Provider Demographics
NPI:1518715317
Name:MILLER, JANELLE (MA, CCC-SLP/L)
Entity type:Individual
Prefix:
First Name:JANELLE
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:MA, CCC-SLP/L
Other - Prefix:
Other - First Name:JANELLE
Other - Middle Name:
Other - Last Name:ARCUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP/L
Mailing Address - Street 1:2424 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-3932
Mailing Address - Country:US
Mailing Address - Phone:630-251-0422
Mailing Address - Fax:
Practice Address - Street 1:2424 LAKE ST
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-3932
Practice Address - Country:US
Practice Address - Phone:630-251-0422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146012275235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist