Provider Demographics
NPI:1265930358
Name:MILLER, CHELSEY DANIELLE (SLP, CLC)
Entity type:Individual
Prefix:
First Name:CHELSEY
Middle Name:DANIELLE
Last Name:MILLER
Suffix:
Gender:F
Credentials:SLP, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10606 RACHEL LN
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-1365
Mailing Address - Country:US
Mailing Address - Phone:815-590-2311
Mailing Address - Fax:
Practice Address - Street 1:10606 RACHEL LN
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-1365
Practice Address - Country:US
Practice Address - Phone:815-590-2311
Practice Address - Fax:773-439-2564
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-24
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146013193235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty