Individual provider Active NPI

Lauren Miller, PSYD

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1295889814
Registry record updated Dec 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071-006440 Issued in IL
Practice address
1 E Superior St
Ste 300
Chicago, IL 60611-2507
Phone
(312) 475-0505
Fax
(312) 475-0551
NPI assigned
Jan 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071-006440 IL Primary

Addresses

Primary practice location

1 E Superior St
Ste 300
Chicago, IL 60611-2507

Mailing address

5825 S Blackstone Ave
Chicago, IL 60637-5203
Phone (312) 245-9910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110418000819 IL Practitioner - Clinical Psychologist 5496939365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1 E Superior St
Suite 301
Chicago, IL 60611-2595
Phone (312) 475-0505

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071-006440ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lauren Miller PSYD LLC Clinical CurrentSince Mar 25, 2011 Accepting new patients

Locations

1 E Superior St
Ste 301
Chicago, IL 60611
Phone (312) 475-0505

1 E Superior St
Ste 300
Chicago, IL 60611
Phone (312) 475-0505

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323993600000",
    "number": "1295889814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5825 S BLACKSTONE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606375203",
            "telephone_number": "312-245-9910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 E SUPERIOR ST",
            "address_2": "STE 300",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112507",
            "telephone_number": "312-475-0505",
            "fax_number": "312-475-0551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "LAUREN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2011-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-006440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.