Healthcare Provider Details

I. General information

NPI: 1316802457
Provider Name (Legal Business Name): EXCEPTIONAL MINDS PSYCHOLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2025
Last Update Date: 12/22/2025
Certification Date: 12/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 W FRONTAGE RD STE 3250
NORTHFIELD IL
60093-1282
US

IV. Provider business mailing address

540 W FRONTAGE RD STE 3250
NORTHFIELD IL
60093-1282
US

V. Phone/Fax

Practice location:
  • Phone: 773-916-6740
  • Fax:
Mailing address:
  • Phone: 773-916-6740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. COLLEEN MILLER
Title or Position: OWNER
Credential: PSYD
Phone: 773-916-6740