SearchIllinois343900000X

Shatonna Miller

NPI 1225875305 · on the registry since 2024 · sole proprietor

Practice

Address
16431 Dobson Ave
South Holland, IL 60473
Phone
(773) 678-0886
Organisation at this address
Gods Grace Inc
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy
343900000X
343900000X
Also registered as
172A00000X
342000000X
Licence states on file
IL
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2024-07-22

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois