Healthcare Provider Details

I. General information

NPI: 1609671700
Provider Name (Legal Business Name): ALISSA JOANNE MILLAR OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2025
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1409 W CARROLL AVE
CHICAGO IL
60607-1105
US

IV. Provider business mailing address

1409 W CARROLL AVE
CHICAGO IL
60607-1105
US

V. Phone/Fax

Practice location:
  • Phone: 312-733-0883
  • Fax:
Mailing address:
  • Phone: 312-733-0883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: