Individual
GRACE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1653 W CONGRESS PKWY, CHICAGO, IL 60612-3833
(312) 942-8612
Mailing address
1653 W CONGRESS PKWY, CHICAGO, IL 60612-3833
(312) 942-8612
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
071.010673
IL
103TC0700X
Clinical Psychologist
Primary
071.010673
IL
Other
Enumeration date
02/02/2022
Last updated
03/23/2022
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