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NPI Code Detail

MEDICARE: JACOB MILLER DPT

MEDICARE: JACOB MILLER DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist11-08086KS

General Provider Information

NPI Number : 1063377984
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACOB MILLER DPT
Provider Business Mailing Address
First Line : 2122 YORK RD STE 300
Second Line :
City : OAK BROOK
State : IL
Zip : 60523-1925
Country : US
Telephone Number : 630-575-6200
Fax Number :
Provider Business Practice Location Address
First Line : 141 S PARKER ST
Second Line :
City : OLATHE
State : KS
Zip : 66061-4043
Country : US
Telephone Number : 913-538-5453
Fax Number : 913-361-1051
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2025
Last Update Date : 02/10/2026

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