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General NPI Number Information
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NPI Number | 1841089869
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Entity Type | Individual
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Provider Name | CASSANDRA MILLER
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Gender |
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Dates
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Enumeration Date | 05/05/2025
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 820 NORTH BLVD
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City | OAK PARK
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State | IL
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Zip | 60301-1351
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Country | US
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Telephone | 708-524-2445
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Fax |
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Provider Business Mailing Address
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Address Line | 1900 SOMERSET CT
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City | ROMEOVILLE
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State | IL
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Zip | 60446-3988
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Country | US
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Telephone | 815-641-9207
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 056.016494
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License Number State | IL
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