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Elleis Miranda, BS

Developmental Therapist in Chicago, IL. Individual provider (NPI-1).

NPI number1164048567
StatusActive
Last updated in NPPESMay 9, 2022

Details

NPI
1164048567
Entity type
Individual (NPI-1)
Name
Ms. Elleis Miranda
Credential
BS
Sex
Female
Sole proprietor
No
Enumeration date
Jun 22, 2020
Certification date
May 9, 2022
Last updated
May 9, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
222Q00000X Developmental Therapist––Yes

Practice location

304 N Loomis St
Chicago, IL 60607-1147

Phone 312-243-8487

Mailing address

304 N Loomis St
Chicago, IL 60607-1147

Phone 312-243-8487

Other practice locations

1409 W Carroll Ave
Chicago, IL 60607-1105

Phone 312-733-0883

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