Active NPI
Katherine Sullivan Miley, PSY.D.
- Clinical Psychologist
- Geneva, IL
National Provider Identifier
1396060745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071-005292
- Practice address
- 1250 Executive PL
500 Building
Geneva, IL 60134-3807 - Phone
- (630) 232-7457
- NPI assigned
- Mar 29, 2010
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 071-005292 | IL | Primary |
Addresses
Primary practice location
1250 Executive PL
500 Building
Geneva, IL 60134-3807
Mailing address
PO Box 253
Medinah, IL 60157-0253
Phone (847) 590-1814
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 |
|---|---|---|---|
| 071-005292 | IL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269820800000",
"number": "1396060745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 253",
"city": "MEDINAH",
"state": "IL",
"postal_code": "601570253",
"telephone_number": "847-590-1814"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1250 EXECUTIVE PL",
"address_2": "500 BUILDING",
"city": "GENEVA",
"state": "IL",
"postal_code": "601343807",
"telephone_number": "630-232-7457"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILEY",
"first_name": "KATHERINE",
"middle_name": "SULLIVAN",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-03-29",
"last_updated": "2010-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071-005292",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Geneva, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.