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General NPI Number Information
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NPI Number | 1083902043
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Entity Type | Individual
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Provider Name | KASEY DIANE MILLS PT
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Gender | Female
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Dates
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Enumeration Date | 07/12/2011
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 427 W LIBERTY ST
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City | WAUCONDA
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State | IL
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Zip | 60084-2452
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Country | US
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Telephone | 847-449-7277
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Fax | 847-449-7278
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Provider Business Mailing Address
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Address Line | 33900 HARPER AVE STE 104
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City | CLINTON TWP
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State | MI
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Zip | 48035-4258
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 8672
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 070019808
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License Number State | IL
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