Healthcare Provider Details

I. General information

NPI: 1134255227
Provider Name (Legal Business Name): RAECHEL MILLER DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RAECHEL PERA DPT

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 E 1100 N
CHESTERTON IN
46304-9697
US

IV. Provider business mailing address

502 E 1100 N
CHESTERTON IN
46304-9697
US

V. Phone/Fax

Practice location:
  • Phone: 219-926-5850
  • Fax:
Mailing address:
  • Phone: 219-926-5850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number05009481A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070015581
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: