MEDICARE: MYA S GILLIARD 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
1	225100000X	Physical Therapist	1407408	TX

General Provider Information

NPI Number	:	1497637946
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MYA S GILLIARD 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	:	3309 DALLAS PKWY STE 431
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-6442
Country	:	US
Telephone Number	:	214-427-1626
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2025
Last Update Date	:	08/29/2025

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Directions to “ MYA S GILLIARD DPT” Practice Location

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