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General NPI Number Information
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NPI Number | 1477672459
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Entity Type | Individual
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Provider Name | EILEEN NIEMIERA PHD. LC.P.C.
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Gender | Female
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 02/15/2019
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Provider Practice Location Address
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Address Line | 10610 S CICERO AVE STE 4
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City | OAK LAWN
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State | IL
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Zip | 60453-5298
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Country | US
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Telephone | 708-364-7046
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Fax | 708-364-7048
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Provider Business Mailing Address
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Address Line | 5101 W 105TH ST
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City | OAK LAWN
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State | IL
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Zip | 60453-5122
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Country | US
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Telephone | 708-278-2839
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Fax | 708-422-2839
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 180004583
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License Number State | IL
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