Jennifer E Miller, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085002629 Issued in IL

Practice address

1704 Maple Ave Ste 100
Evanston, IL 60201-3134

Phone

(312) 694-2273

Fax

(312) 694-2299

NPI assigned

Jun 12, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jennifer.miller.1@16494.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Primecare Community Health, Inc.

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1558532739
  Medicare reassignment
• Primecare Community Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1225010911
  NPD
• Primecare Community Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1356622500
  NPD (past)
• Primecare Community Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1730235870
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522800000000",
    "number": "1083656979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR STE 1000",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606118709",
            "telephone_number": "312-695-0665",
            "fax_number": "312-695-6594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1704 MAPLE AVE STE 100",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013134",
            "telephone_number": "312-694-2273",
            "fax_number": "312-694-2299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "680 N Lake Shore Dr Ste 1000",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606118709",
            "country_code": "US",
            "telephone_number": "312-695-0665",
            "fax_number": "312-695-6594",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JENNIFER",
        "middle_name": "E",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2018-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085002629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher G. Miller, LCPC
• Clothield S. Miller, D.C.
• Frederick Eugene Miller, MD
• Heather Marie Miller, DDS
• Janelle Miller, MA, CCC-SLP/L
• Joanne Miller, OTRL
• Kathryn A Miller, MSN, RN, CMSRN
• Kathryn Callaghan Miller, LCPC
• Kevin Miller, MA
• Mallory Miller

• Physician Assistant in Evanston, IL
• Providers in Evanston, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.