MEDICARE: RACHEL L MILLER PT, 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	070014317	IL

General Provider Information

NPI Number	:	1821211392
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL L MILLER PT, DPT

Provider Business Mailing Address
First Line	:	1113 S MILWAUKEE AVE STE 201
Second Line	:
City	:	LIBERTYVILLE
State	:	IL
Zip	:	60048-3777
Country	:	US
Telephone Number	:	847-388-0831
Fax Number	:

Provider Business Practice Location Address
First Line	:	1113 S MILWAUKEE AVE STE 201
Second Line	:
City	:	LIBERTYVILLE
State	:	IL
Zip	:	60048
Country	:	US
Telephone Number	:	847-388-0831
Fax Number	:

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

Provider Enumeration Date	:	04/11/2007
Last Update Date	:	06/05/2018

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