MEDICARE: CATHY MCMILLAN PTA

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	225200000X	Physical Therapy Assistant		IL

General Provider Information

NPI Number	:	1720286925
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHY MCMILLAN PTA

Provider Business Mailing Address
First Line	:	1900 OGDEN AVE
Second Line	:	SUITE 205
City	:	AURORA
State	:	IL
Zip	:	60504-4273
Country	:	US
Telephone Number	:	630-978-6218
Fax Number	:	630-978-6219

Provider Business Practice Location Address
First Line	:	1900 OGDEN AVE
Second Line	:	SUITE 205
City	:	AURORA
State	:	IL
Zip	:	60504-4273
Country	:	US
Telephone Number	:	630-978-6218
Fax Number	:	630-978-6219

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

Provider Enumeration Date	:	07/10/2007
Last Update Date	:	07/10/2007

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Directions to “ CATHY MCMILLAN PTA” Practice Location

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