Provider Demographics
NPI:1538691282
Name:MILLER, PATRICIA A (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:A
Last Name:MILLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1841 S CALUMET AVE
Mailing Address - Street 2:#1903
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-4627
Mailing Address - Country:US
Mailing Address - Phone:847-840-8257
Mailing Address - Fax:
Practice Address - Street 1:1841 S CALUMET AVE
Practice Address - Street 2:#1903
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-4627
Practice Address - Country:US
Practice Address - Phone:847-840-8257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-31
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0188141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical