Healthcare Provider Details

I. General information

NPI: 1053222984
Provider Name (Legal Business Name): EGLE MILAVICKAS LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

928 WARREN AVE # 6
DOWNERS GROVE IL
60515-3631
US

IV. Provider business mailing address

928 WARREN AVE # 6
DOWNERS GROVE IL
60515-3631
US

V. Phone/Fax

Practice location:
  • Phone: 312-882-1438
  • Fax:
Mailing address:
  • Phone: 312-882-1438
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number227012335
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: