Provider Demographics
NPI:1700493848
Name:AMIL, AILA M (PSYD)
Entity type:Individual
Prefix:MS
First Name:AILA
Middle Name:M
Last Name:AMIL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:M
Other - Last Name:AMIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:PO BOX 7410264
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-0264
Mailing Address - Country:US
Mailing Address - Phone:815-942-6323
Mailing Address - Fax:779-210-5541
Practice Address - Street 1:2502 N CLARK ST # 212
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-1850
Practice Address - Country:US
Practice Address - Phone:773-930-9553
Practice Address - Fax:773-688-2637
Is Sole Proprietor?:No
Enumeration Date:2020-09-23
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3855-57103TC0700X
IL071010409103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical