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General NPI Number Information
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NPI Number | 1912230525
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Entity Type | Individual
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Provider Name | HEATHER ANN MEFFLEY MILLER MPT
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Gender | Female
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Dates
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Enumeration Date | 09/14/2009
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Last Update Date | 09/15/2009
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Provider Practice Location Address
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Address Line | 660 N WESTMORELAND RD
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City | LAKE FOREST
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State | IL
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Zip | 60045-1659
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Country | US
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Telephone | 847-535-8060
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Fax | 847-535-7834
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Provider Business Mailing Address
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Address Line | 2408 N SAMSON WAY UNIT 3D
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City | WAUKEGAN
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State | IL
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Zip | 60087-5062
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Country | US
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Telephone | 513-289-1505
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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 | 070.016880
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License Number State | IL
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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 | 009740
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License Number State | OH
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