MEDICARE: MRS. PATRICIA 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
1	1041C0700X	Clinical Social Worker	149.018814	IL

General Provider Information

NPI Number	:	1538691282
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PATRICIA A MILLER LCSW

Provider Business Mailing Address
First Line	:	1841 S CALUMET AVE
Second Line	:	#1903
City	:	CHICAGO
State	:	IL
Zip	:	60616-4627
Country	:	US
Telephone Number	:	847-840-8257
Fax Number	:

Provider Business Practice Location Address
First Line	:	1841 S CALUMET AVE
Second Line	:	#1903
City	:	CHICAGO
State	:	IL
Zip	:	60616-4627
Country	:	US
Telephone Number	:	847-840-8257
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2017
Last Update Date	:	03/31/2017

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