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General NPI Number Information
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NPI Number | 1598080194
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Entity Type | Individual
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Provider Name | SUZANNE K MILLER M.ED., PH.D.
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Gender | Female
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Dates
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Enumeration Date | 04/07/2010
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Last Update Date | 11/17/2013
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Provider Practice Location Address
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Address Line | 1500 SKOKIE BLVD SUITE 560
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City | NORTHBROOK
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State | IL
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Zip | 60062-4121
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Country | US
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Telephone | 312-846-6932
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Fax | 312-846-1219
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Provider Business Mailing Address
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Address Line | 11 E WALTON ST UNIT 3502
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City | CHICAGO
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State | IL
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Zip | 60611-5442
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Country | US
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Telephone | 312-846-1219
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Fax | 312-846-1219
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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 | 071.007824
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License Number State | IL
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