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General NPI Number Information
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NPI Number | 1235545047
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Entity Type | Individual
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Provider Name | MR. JOSEPH LEON MILLER
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Gender | Male
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Dates
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Enumeration Date | 07/01/2014
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Last Update Date | 07/17/2014
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Provider Practice Location Address
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Address Line | 240 SAUNDERS RD
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City | RIVERWOODS
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State | IL
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Zip | 60015-3835
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Country | US
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Telephone | 612-616-0108
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Fax |
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Provider Business Mailing Address
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Address Line | 8912 EWING AVE #2
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City | EVANSTON
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State | IL
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Zip | 60203-1900
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Country | US
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Telephone | 612-616-0108
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 227.006327
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License Number State | IL
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