Stacie Danielle Miller

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

37003512A Issued in IN

Practice address

17715 Harwood Ave
Homewood, IL 60430-1317

Phone

(708) 306-1122

NPI assigned

May 18, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1684368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1295426310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17715 HARWOOD AVE",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604301317",
            "telephone_number": "708-306-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17715 HARWOOD AVE",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604301317",
            "telephone_number": "708-306-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "STACIE",
        "middle_name": "DANIELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-18",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IN",
            "license": "37003512A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Leigh Miller, PHARMD
• Donald A. Miller, D.D.S.,M.S.
• Jillian Andrea Miller
• Kyle Raymond Miller, MA
• Sheree N Miller
• Ruth Ann Mills, CHIROPRACTOR
• Mary Mims
• Mindful Wellness Counseling
• Mindful Wellness Counseling Group
• Minds Empowered Counseling

• Registered Dietitian in Homewood, IL
• Providers in Homewood, IL by specialty
• Registered Dietitian in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.