Provider Demographics
NPI:1194245324
Name:DOWELL MILLS, SAMEKA RENEE (NP)
Entity type:Individual
Prefix:
First Name:SAMEKA
Middle Name:RENEE
Last Name:DOWELL MILLS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18125 ROY ST UNIT 622
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:IL
Mailing Address - Zip Code:60438-6655
Mailing Address - Country:US
Mailing Address - Phone:773-219-6483
Mailing Address - Fax:
Practice Address - Street 1:18125 ROY ST UNIT 622
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:IL
Practice Address - Zip Code:60438-6655
Practice Address - Country:US
Practice Address - Phone:773-345-7529
Practice Address - Fax:773-825-8327
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-20
Last Update Date:2023-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV832880363LF0000X
IN28191437A363LF0000X
COC-APN.0992656-C-NP363LF0000X, 363LP0808X
IL277001225363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily