Individual
MARIANNE I MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
1725 W HARRISON ST, SUITE 945, CHICAGO, IL 60612-3841
(312) 563-2132
(312) 563-2131
Mailing address
1725 W HARRISON ST, SUITE 945, CHICAGO, IL 60612-3841
(312) 563-2132
(312) 563-2131
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
20172
CA
363LP0200X
Pediatric Nurse Practitioner
Primary
209009289
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20172
NP LICENSE NUMBER
CA
01
—
209.009289
ILLINOIS NP LICENSE NUMBER
IL
Enumeration date
02/16/2011
Last updated
03/22/2012
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