Bertha M Miller

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

17850 Baker Ave
Country Club Hills, IL 60478-4729

Phone

(708) 754-8815

NPI assigned

Dec 23, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Grand Prairie Services

  • Federally Qualified Health Center (FQHC)
  • Chicago Heights, IL
  • NPI 1447723564
  NPD (past)
• Grand Prairie Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Country Club Hills, IL
  • NPI 1730363458
  NPD (past)

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

{
    "created_epoch": "1293062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293062400000",
    "number": "1447554969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17746 OAK PARK AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604773936",
            "telephone_number": "708-444-1012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17850 BAKER AVE",
            "city": "COUNTRY CLUB HILLS",
            "state": "IL",
            "postal_code": "604784729",
            "telephone_number": "708-754-8815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "BERTHA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-23",
        "last_updated": "2010-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lovely Layed Wig Shop LLC
• Lynnette Degraffenreid
• Madison Paige Speech and Language Therapy Inc.
• Marshall Transportation,Inc.
• Takahya McIntyre, MSW, LCSW
• Miracles Revealed Chiropractic Wellness Center
• Miracles Revealed Chiropractic Wellness Center
• Mission Driven Transportation Inc
• Arlene Mitchell, LSW
• Kenneth Mogbo

• Behavior Analyst in Country Club Hills, IL
• Providers in Country Club Hills, IL by specialty
• Behavior Analyst in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.

Verify at the official NPI Registry.