Provider Demographics
NPI:1710098876
Name:DR. AMY D. MILLER AND ASSOCIATES, INC.
Entity Type:Organization
Organization Name:DR. AMY D. MILLER AND ASSOCIATES, INC.
Other - Org Name:ADVANCED PSYCHOLOGICAL SERVICES, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:D
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:847-519-7770
Mailing Address - Street 1:1305 REMINGTON RD
Mailing Address - Street 2:SUITE T
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4833
Mailing Address - Country:US
Mailing Address - Phone:847-519-7770
Mailing Address - Fax:847-519-9089
Practice Address - Street 1:1305 REMINGTON RD
Practice Address - Street 2:SUITE T
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4833
Practice Address - Country:US
Practice Address - Phone:847-519-7770
Practice Address - Fax:847-519-9089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL060-007525(071005912103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL21623273OtherBCBS PROVIDER ID
IL=========OtherFEDERAL ID#