Active NPI
Grace Miller, PHD
- Clinical Psychologist
- Chicago, IL
National Provider Identifier
1952054553
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071.010673
- Practice address
- 1653 W Congress Pkwy
Chicago, IL 60612-3833 - Phone
- (312) 942-8612
- NPI assigned
- Feb 2, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 071.010673 | IL | |
| Clinical Psychologist | 103TC0700X | 071.010673 | IL | Primary |
Addresses
Primary practice location
1653 W Congress Pkwy
Chicago, IL 60612-3833
Mailing address
1653 W Congress Pkwy
Chicago, IL 60612-3833
Phone (312) 942-8612
Other names 1
- Grace Kathryn Maloney
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071.010673 | IL | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rush University Medical Group | Clinical | Current | Accepting new patients |
Locations
1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875
1653 W Congress Pkwy
Chicago, IL 60612
Phone (312) 942-3138
75 Remittance Dr
Dept 1611
Chicago, IL 60675
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": "1643760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647993600000",
"number": "1952054553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1653 W CONGRESS PKWY",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123833",
"telephone_number": "312-942-8612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1653 W CONGRESS PKWY",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123833",
"telephone_number": "312-942-8612"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "GRACE",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-02",
"last_updated": "2022-03-23",
"certification_date": "2022-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "IL",
"license": "071.010673",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071.010673",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "GRACE",
"last_name": "MALONEY",
"middle_name": "KATHRYN",
"code": "1",
"type": "Former Name"
}
]
}
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 Mar 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.