Individual provider Active NPI

Nicole Miller, MA CCC-SLP

  • Speech-Language Pathologist
  • Chicago, IL
National Provider Identifier
1982056677
Registry record updated Jul 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
9882 Issued in MA
Practice address
360 W Hubbard St Apt 2303
Chicago, IL 60654
Phone
(908) 907-7081
NPI assigned
Jul 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 9882 MA Primary

Addresses

Primary practice location

360 W Hubbard St Apt 2303
Chicago, IL 60654

Mailing address

360 W Hubbard St Apt 2303
Chicago, IL 60654-5753

Other practice location 1

7 Loring Hills Ave
Salem, MA 01970-4267
Phone (978) 741-5700

Other practice location 2

7 Loring Hills Ave
Salem, MA 01970-4267
Phone (978) 741-5700

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nmiller@sahchicago.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190724000690 IL Practitioner - Qualified Speech Language Pathologist 6305172768 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
9882MAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Memorycare Corporation Speech-Language Pathologist CurrentSince Jun 21, 2019 Accepting new patients
Council for Jewish Elderly CurrentSince Jan 16, 2023 Accepting new patients
Council for Jewish Elderly Current Accepting new patients

Locations

3003 W Touhy Ave
Chicago, IL 60645
Phone (773) 508-1000

1601 Lake Cook Rd
Deerfield, IL 60015
Phone (773) 508-4475

Organizations & group practices 3

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": "1467763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562544000000",
    "number": "1982056677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 W HUBBARD ST APT 2303",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606545753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 W HUBBARD ST APT 2303",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60654",
            "telephone_number": "908-907-7081"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7 Loring Hills Ave",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "MA",
            "postal_code": "019704267",
            "country_code": "US",
            "telephone_number": "978-741-5700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7 Loring Hills Ave",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "MA",
            "postal_code": "019704267",
            "country_code": "US",
            "telephone_number": "978-741-5700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "NICOLE",
        "credential": "MA CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-06",
        "last_updated": "2019-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "9882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nmiller@sahchicago.org",
            "affiliation": "N",
            "address_1": "360 W Hubbard St Apt 2303",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606545753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.