Healthcare Provider Details

I. General information

NPI: 1265558845
Provider Name (Legal Business Name): DAWN M MILLER SPEECH THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 S UNIVERSITY ST
NORMAL IL
61790-4720
US

IV. Provider business mailing address

275 S UNIVERSITY ST
NORMAL IL
61790-4720
US

V. Phone/Fax

Practice location:
  • Phone: 309-438-8641
  • Fax: 800-611-3697
Mailing address:
  • Phone: 309-438-8641
  • Fax: 800-611-3697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number146-006616
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: