Millenova

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MILLENOVA

Practice address

233 E Erie St Ste 510
Chicago, IL 60611-5935

Phone

(312) 274-1928

Fax

(312) 274-1879

NPI assigned

Jul 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Carolyn Coulam, MD

Title

Director

Phone

(312) 274-1928

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208131200000",
    "number": "1689871774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5320 S RAINBOW BLVD",
            "address_2": "SUITE 300",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891181840",
            "telephone_number": "702-794-0073",
            "fax_number": "702-696-0554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 E ERIE ST STE 510",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115935",
            "telephone_number": "312-274-1928",
            "fax_number": "312-274-1879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLENOVA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-02",
        "last_updated": "2008-04-14",
        "status": "A",
        "authorized_official_last_name": "COULAM",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "312-274-1928",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Millennium Park Dermatology, S.C.
• Millennium Park Medical Associates, S.C.
• Millennium Park Psychological Associates, LLC
• Millennium Park Smiles, LLC
• Millennium Surgical, Inc
• Andrea M Miller Finch, D.D.S.
• Elizabeth Miller Robbins, PSY.D.
• Megan Miller-Attang, LCSW
• Zoe A Miller-Lee
• Donna Lee Miller-Winston, LCSW,CADC

• Clinical Medical Laboratory in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Medical Laboratory in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.