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NPI Code Detail

MEDICARE: MS. LOUISE A. MILLER LCSW

MEDICARE: MS. LOUISE A. MILLER LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerIL

General Provider Information

NPI Number : 1215072772
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LOUISE A. MILLER LCSW
Provider Business Mailing Address
First Line : 5450 S DORCHESTER AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60615-5309
Country : US
Telephone Number : 773-684-6942
Fax Number :
Provider Business Practice Location Address
First Line : 6501 S PROMONTORY DR
Second Line :
City : CHICAGO
State : IL
Zip : 60649-1003
Country : US
Telephone Number : 773-256-5767
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2007
Last Update Date : 07/08/2007

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