Provider Demographics
NPI:1134993116
Name:MILLER, HEATHER (DNP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6238 26TH ST UNIT 501
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402-5407
Mailing Address - Country:US
Mailing Address - Phone:630-819-9143
Mailing Address - Fax:
Practice Address - Street 1:1 E OAKHILL DR STE 100
Practice Address - Street 2:
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-5540
Practice Address - Country:US
Practice Address - Phone:630-672-4266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-10
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209028755363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health