Active NPI
Shekena Ann Miller
- Substance Use Disorder Rehabilitation Clinic/Center
- Chicago, IL
National Provider Identifier
1306477989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Substance Use Disorder Rehabilitation Clinic/Center
- License
- A-7512-0001-A
- Practice address
- 226 W Ontario St Ste 400C
Chicago, IL 60654-3619 - Phone
- (312) 912-7008
- Fax
- (312) 533-2842
- NPI assigned
- Jan 31, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X | A-7512-0001-A | IL | Primary |
Addresses
Primary practice location
226 W Ontario St Ste 400C
Chicago, IL 60654-3619
Mailing address
226 W Ontario St Ste 400C
Chicago, IL 60654-3619
Phone (312) 912-7008
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A-7512-0001-A | IL | MD | Substance Use Disorder Rehabilitation Clinic/Center |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580428800000",
"number": "1306477989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "226 W ONTARIO ST STE 400C",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606543619",
"telephone_number": "312-912-7008",
"fax_number": "312-533-2842"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "226 W ONTARIO ST STE 400C",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606543619",
"telephone_number": "312-912-7008",
"fax_number": "312-533-2842"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "SHEKENA",
"middle_name": "ANN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-01-31",
"last_updated": "2020-01-31",
"certification_date": "2020-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "261QR0405X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
"state": "IL",
"license": "A-7512-0001-A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.