NPIMap

Individual provider Active NPI

Elliot F. Miller, MD

  • Internal Medicine Physician
  • Libertyville, IL
National Provider Identifier
1164441572
Registry record updated Mar 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-063303 Issued in IL
Practice address
1800 Hollister Dr
Libertyville, IL 60048-5263
Phone
(847) 816-3084
Fax
(847) 816-0031
NPI assigned
Jul 18, 2006
Last updated
Mar 12, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036-063303 IL Primary

Addresses

Primary practice location

1800 Hollister Dr
Libertyville, IL 60048-5263

Mailing address

1800 Hollister Dr Ste 211
Libertyville, IL 60048-5266
Phone (847) 816-3084

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110210000582 IL Practitioner - Internal Medicine 2567642390 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Wayne State University School of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lake Forest Internal Medicine LTDGroup PAC ID 3173703097, 2 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

1800 Hollister Dr
Suite 211
Libertyville, IL 60048-5266
Phone (847) 816-3084

2600 Compass Rd
Glenview, IL 60026-8001

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
19.5 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
64.99

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-063303ILMDInternal Medicine Physician

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DHDIBA/Endpoint/DHDIBA

Organizations & group practices 2

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

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426118400000",
    "number": "1164441572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 HOLLISTER DR STE 211",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485266",
            "telephone_number": "847-816-3084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 HOLLISTER DR",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485263",
            "telephone_number": "847-816-3084",
            "fax_number": "847-816-0031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ELLIOT",
        "middle_name": "F.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2015-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-063303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

Verify at the official NPI Registry.