| Ernest Miller, MD | |
|
10 Doctors Park, Gibson City, IL 60936-2004 | |
| (217) 784-4540 | |
| (217) 784-4542 |
| Full Name | Ernest Miller |
|---|---|
| Gender | Male |
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 10 Doctors Park, Gibson City, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922666429 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 69079 (Arizona) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 036175347 (Illinois) | Primary |
| Entity Name | Maricopa County Special Health Care District |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073576740 PECOS PAC ID: 4688583651 Enrollment ID: O20031204000823 |
| Entity Name | District Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1336472448 PECOS PAC ID: 7315086691 Enrollment ID: O20091125000583 |
| Mailing Address | Practice Location Address |
|---|---|
| Ernest Miller, MD 1120 N Melvin St, Gibson City, IL 60936-1477 Ph: (217) 784-4251 | Ernest Miller, MD 10 Doctors Park, Gibson City, IL 60936-2004 Ph: (217) 784-4540 |
Ajay Jeetwani, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 4 Doctors Park, Gibson City, IL 60936 Phone: 217-784-4540 Fax: 217-784-4542 | |
Christine Grundeman, Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1120 N Melvin St, Gibson City, IL 60936 Phone: 217-784-4540 Fax: 217-784-4542 | |
Dr. Trilok Shah, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 4 Doctors Park, Gibson City, IL 60936 Phone: 773-916-7595 | |
Benjamin Weger, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 10 Doctors Park, Gibson City, IL 60936 Phone: 217-784-4540 |