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NPI Code Detail

MEDICARE: LEO MILLER

MEDICARE:   LEO  MILLER
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
1101YP2500XProfessional CounselorIL

General Provider Information

NPI Number : 1639131956
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEO MILLER
Provider Business Mailing Address
First Line : 6724 N OCONTO AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60631-3916
Country : US
Telephone Number : 773-631-1929
Fax Number :
Provider Business Practice Location Address
First Line : 6724 N OCONTO AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60631-3916
Country : US
Telephone Number : 312-208-6325
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2006
Last Update Date : 07/08/2007

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Directions to “ LEO MILLER ” Practice Location

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