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General NPI Number Information
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NPI Number | 1740717578
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Entity Type | Individual
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Provider Name | SARA MILLER
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Gender | Female
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Dates
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Enumeration Date | 05/11/2017
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Last Update Date | 05/11/2017
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Provider Practice Location Address
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Address Line | 1550 S STATE ST
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City | CHICAGO
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State | IL
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Zip | 60605-7805
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Country | US
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Telephone | 800-361-6880
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Fax | 708-845-5505
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Provider Business Mailing Address
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Address Line | 15127 S 73RD AVE SUITE G
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City | ORLAND PARK
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State | IL
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Zip | 60462-4398
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Country | US
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Telephone | 800-361-6880
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Fax | 708-845-5505
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149.009029
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License Number State | IL
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