Individual
DANIELLE LANISE MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8126 S KINGSTON AVE, 2ND FL., CHICAGO, IL 60617-1231
(773) 991-3219
(773) 375-3219
Mailing address
8126 S KINGSTON AVE, 2ND FL., CHICAGO, IL 60617-1231
(773) 991-3219
(773) 375-3219
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DM06470202P
CREDENTIAL NUMBER
IL
Enumeration date
04/30/2007
Last updated
07/08/2007
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