Active NPI
Mary Carroll Miller, MD
- Psychiatry Physician
- Quincy, IL
National Provider Identifier
1780685495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- Practice address
- 2628 Broadway St
Quincy, IL 62301-3637 - Phone
- (217) 224-1744
- Fax
- (217) 222-5827
- NPI assigned
- Aug 3, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | IL | Primary |
Addresses
Primary practice location
2628 Broadway St
Quincy, IL 62301-3637
Mailing address
124 S 20TH St
Quincy, IL 62301-4306
Phone (217) 224-0513
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-083011 | IL | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mary C. Miller MD PC | Psychiatry | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1780685495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "124 S 20TH ST",
"city": "QUINCY",
"state": "IL",
"postal_code": "623014306",
"telephone_number": "217-224-0513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2628 BROADWAY ST",
"city": "QUINCY",
"state": "IL",
"postal_code": "623013637",
"telephone_number": "217-224-1744",
"fax_number": "217-222-5827"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "MARY",
"middle_name": "CARROLL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-03",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Quincy, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.