Provider Information for 1356322804
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Mrs. MARY E MILLER L.S.W.
Sex: Female
NPI: 1356322804
Last Updated: 2007-07-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1356322804 | ||||||||
| Enumeration Date | 2005-11-10 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 746 EUCLID AVE GLEN ELLYN, IL 60137-3836 United States Phone: 630-858-4161 | Fax: | ||||||||
| Primary Practice Address | 530 GLEN AVE ROMEOVILLE, IL 60446-1211 United States Phone: 630-624-6743 | Fax: | ||||||||
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