Provider Demographics
NPI:1649291915
Name:TRIGUEROS-MILLAR, JEANNE E (MSW)
Entity type:Individual
Prefix:
First Name:JEANNE
Middle Name:E
Last Name:TRIGUEROS-MILLAR
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:946 E THACKER ST
Mailing Address - Street 2:SUITE 132
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-3202
Mailing Address - Country:US
Mailing Address - Phone:847-909-2037
Mailing Address - Fax:847-375-6996
Practice Address - Street 1:946 E THACKER ST
Practice Address - Street 2:SUITE 132
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-3202
Practice Address - Country:US
Practice Address - Phone:847-909-2037
Practice Address - Fax:847-375-6996
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6709-1231041C0700X
IL149-0068701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43554000Medicaid
WI43554000Medicaid