Individual provider · Type 1 NPI

Miata Lanae Minor

Massage Therapist · Chicago, IL

NPI number 1629938717 Active

Practice location

1614 E 53rd St Unit 21
Chicago, IL 60615-4210

Call (312) 613-1651 Map

Mailing address

4307 S Prairie Ave Unit 312
Chicago, IL 60653-3725

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X227.024341 (IL)

Massage Therapist: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

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About NPI 1629938717

Miata Lanae Minor's National Provider Identifier is 1629938717, issued on Nov 12, 2025. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Chicago, IL. The record was last updated on Nov 12, 2025.