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NPI Code Detail

MEDICARE: MILALLY O MALIMAS PT

MEDICARE: MILALLY O MALIMAS PT
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 Therapist
2225100000XPhysical Therapist05010262AIN

General Provider Information

NPI Number : 1578514741
Entity Type Code : Individual
Provider Name (Legal Business Name) : MILALLY O MALIMAS PT
Provider Business Mailing Address
First Line : 9633 RIDGELAND AVE APT 1D
Second Line :
City : OAK LAWN
State : IL
Zip : 60453-2751
Country : US
Telephone Number : 708-856-4285
Fax Number : 708-529-0123
Provider Business Practice Location Address
First Line : 14901 CAREY RD
Second Line :
City : CARMEL
State : IN
Zip : 46033-6000
Country : US
Telephone Number : 877-407-3422
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2006
Last Update Date : 04/26/2025

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Directions to “ MILALLY O MALIMAS PT” Practice Location

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