Active NPI
Kathryn Lee Miller, PHD
- Clinical Psychologist
- Naperville, IL
National Provider Identifier
1962950717
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 017.010297
- Practice address
- 4055 S Route 59 FL 1
Naperville, IL 60564-5803 - Phone
- (872) 246-0651
- NPI assigned
- Sep 21, 2016
- 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 | 017.010297 | IL | Primary |
Addresses
Primary practice location
4055 S Route 59 FL 1
Naperville, IL 60564-5803
Mailing address
4055 S Route 59 FL 1
Naperville, IL 60564-5803
Phone (872) 246-0651
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 017.010297 | IL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736985600000",
"number": "1962950717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4055 S ROUTE 59 FL 1",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605645803",
"telephone_number": "872-246-0651"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4055 S ROUTE 59 FL 1",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605645803",
"telephone_number": "872-246-0651"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "KATHRYN",
"middle_name": "LEE",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-09-21",
"last_updated": "2025-01-16",
"certification_date": "2025-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "017.010297",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Naperville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.