Individual provider Active NPI

Nicole Miller, L.M.T.

  • Massage Therapist
  • Chicago, IL
National Provider Identifier
1376950550
Registry record updated Jul 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
227.009190 Issued in IL
Practice address
5215 N Ravenswood Ave
Suite 105
Chicago, IL 60640-1668
Phone
(773) 878-7330
NPI assigned
Jul 19, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 227.009190 IL Primary

Addresses

Primary practice location

5215 N Ravenswood Ave
Suite 105
Chicago, IL 60640-1668

Mailing address

2137 W Cornelia Ave Apt 2W
Chicago, IL 60618-6130
Phone (773) 557-2363

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

LicenseStateTypeSpecialty
227.009190ILMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Todd C Renn, P.C. PastSince Jun 29, 2018 Accepting new patients
Essential Health Solutions Inc Past Accepting new patients

Organizations & group practices 2

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": "1405728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405728000000",
    "number": "1376950550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2137 W CORNELIA AVE APT 2W",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606186130",
            "telephone_number": "773-557-2363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5215 N RAVENSWOOD AVE",
            "address_2": "SUITE 105",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401668",
            "telephone_number": "773-878-7330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "NICOLE",
        "name_prefix": "Miss",
        "credential": "L.M.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-19",
        "last_updated": "2014-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IL",
            "license": "227.009190",
            "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 Jul 19, 2014; 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.