Healthcare Provider Details

I. General information

NPI: 1316231491
Provider Name (Legal Business Name): MARIA ABBOTT MILLER MA, LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2011
Last Update Date: 04/01/2024
Certification Date: 04/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10537 S ROBERTS RD
PALOS HILLS IL
60465-1933
US

IV. Provider business mailing address

10537 S ROBERTS RD
PALOS HILLS IL
60465-1933
US

V. Phone/Fax

Practice location:
  • Phone: 708-974-5100
  • Fax: 708-974-2498
Mailing address:
  • Phone: 708-974-5100
  • Fax: 708-974-2498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180008584
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: