Provider Demographics
NPI:1437731965
Name:MILLER, RACHEL DYANN (LMFT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:DYANN
Last Name:MILLER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:747 N WABASH AVE APT 703
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2530
Mailing Address - Country:US
Mailing Address - Phone:219-775-0678
Mailing Address - Fax:
Practice Address - Street 1:1165 N CLARK ST STE 411
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-7473
Practice Address - Country:US
Practice Address - Phone:312-626-4945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-23
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL166001449106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist