Individual provider Active NPI

Kristin Lucille Miller, M.D.

  • Vascular Neurology Physician
  • Chicago, IL
National Provider Identifier
1467866723
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Neurology PhysicianTaxonomy code 2084V0102X
License
036149113 Issued in IL
Practice address
259 E Erie St Ste 1900
Chicago, IL 60611-3246
Phone
(312) 695-7950
Fax
(312) 695-5747
NPI assigned
Jun 16, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 4301114314 MI
Vascular Neurology Physician 2084V0102X 036149113 IL Primary
Neurology Physician 2084N0400X 036.149113 IL

Addresses

Primary practice location

259 E Erie St Ste 1900
Chicago, IL 60611-3246

Mailing address

259 E Erie St Ste 1900
Chicago, IL 60611-3246
Phone (312) 695-7950

Other practice location 1

1500 E Medical Center Dr
Ann Arbor, MI 48109-5000
Phone (734) 936-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190812002526 IL Practitioner - Neurology 1052602315 Reassigns benefits to 2 organizations
I20210727002858 MI Practitioner - Neurology 1052602315 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
George Washington University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

259 E Erie St
Suite 1900
Chicago, IL 60611-3246
Phone (312) 695-7950

Hospital & facility affiliations

  • Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Northwestern Lake Forest Hospital Hospital, Lake Forest, IL, CCN 140130
  • Palos Community Hospital Hospital, Palos Heights, IL, CCN 140062

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.149113ILMDNeurology Physician
4301114314MIMDNeurology Physician
036149113ILMDVascular Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan Current Accepting new patients
The Board of Trustees of the University of Illinois Neurology CurrentSince Jul 15, 2019 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2023 Accepting new patients
Regents of the University of Michigan CurrentSince Jul 13, 2021 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Jul 15, 2019 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2023 Accepting new patients
Regents of the University of Michigan Neurology CurrentSince Jul 13, 2021 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

259 E Erie St
Ste 1900
Chicago, IL 60611

1740 W Taylor St
Chicago, IL 60612
Phone (312) 355-4000

912 S Wood St
Chicago, IL 60612
Phone (312) 996-2200

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

912 S Wood St
#855N
Chicago, IL 60612

2800 W 95th St
Evergreen Pk, IL 60805
Phone (708) 229-5104

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

Organizations & group practices 8

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.

Hospital & facility affiliations 6

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": "1402876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1467866723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST STE 1900",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113246",
            "telephone_number": "312-695-7950",
            "fax_number": "312-695-5747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST STE 1900",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113246",
            "telephone_number": "312-695-7950",
            "fax_number": "312-695-5747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 E Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481095000",
            "country_code": "US",
            "telephone_number": "734-936-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KRISTIN",
        "middle_name": "LUCILLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-16",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "4301114314",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "IL",
            "license": "036149113",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036.149113",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.