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General NPI Number Information
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NPI Number | 1295889814
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Entity Type | Individual
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Provider Name | LAUREN MILLER PSYD
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Gender | Female
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 12/16/2011
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Provider Practice Location Address
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Address Line | 1 E SUPERIOR ST STE 300
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City | CHICAGO
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State | IL
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Zip | 60611-2507
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Country | US
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Telephone | 312-475-0505
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Fax | 312-475-0551
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Provider Business Mailing Address
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Address Line | 5825 S BLACKSTONE AVE
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City | CHICAGO
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State | IL
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Zip | 60637-5203
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Country | US
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Telephone | 312-245-9910
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071-006440
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License Number State | IL
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