MEDICARE: ELLEN BIEMILLER CNS, LDN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133N00000X	Nutritionist

General Provider Information

NPI Number	:	1396400966
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELLEN BIEMILLER CNS, LDN

Provider Business Mailing Address
First Line	:	111 N WABASH AVE # 3178
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60602-1903
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 N WABASH AVE # 3178
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60602-1903
Country	:	US
Telephone Number	:	919-724-5825
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2021
Last Update Date	:	10/19/2023

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