Miller, Antoinette Marie

Miller, Antoinette Marie is an individual health care provider with primary practice located at 3331 W Deyoung St Ste 301 , Marion IL 62959-5898. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Miller, Antoinette Marie can be contacted via phone (618) 998-7239.

Contact Information

Primary practice address
3331 W Deyoung St Ste 301 Marion IL 62959-5898
Phone: (618) 998-7239
Fax: (618) 998-4365
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 209015920 Illinois

Profile Details

NPI number 1053854729
LBN Legal business name Miller, Antoinette Marie
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 29th, 2016
Last updated Jun 5th, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053854729 NPPES
Illinois MEDICAID 1053854729

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