Organization Name: | SURESTEP |
NPI Number: | 1124464912 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | AARON MILLER (OWNER/PHYSICIAN) |
Mailing Address: | 471 Briargate Dr South Elgin |
State: | IL US |
Postal Code: | 601772225 |
Phone Number: | 2245358624 |
Fax Number: | 8474292078 |
NPI Enumeration Date: | 05/20/2013 |
NPI Last Update Date: | 05/20/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084A0401X |
License Number: | 036.131190 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Psychiatry & Neurology |
Taxonomy Specialization: | Addiction Medicine |
Taxonomy Definition: | A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |