Provider Demographics
NPI:1528500832
Name:MILLER, MARION JEAN (RN)
Entity type:Individual
Prefix:MRS
First Name:MARION
Middle Name:JEAN
Last Name:MILLER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:888 S EDGELAWN DR
Mailing Address - Street 2:SUITE 1771
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-5283
Mailing Address - Country:US
Mailing Address - Phone:630-892-7417
Mailing Address - Fax:630-892-7461
Practice Address - Street 1:1190 INDEPENDENCE AVE
Practice Address - Street 2:
Practice Address - City:ELBURN
Practice Address - State:IL
Practice Address - Zip Code:60119-7833
Practice Address - Country:US
Practice Address - Phone:630-365-1163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-17
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.163250163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse