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NPI Code Detail

MEDICARE: CAROL B MILLER P.T.

MEDICARE:   CAROL B MILLER  P.T.
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
1225100000XPhysical TherapistIL

General Provider Information

NPI Number : 1841404886
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROL B MILLER P.T.
Provider Business Mailing Address
First Line : 8657 W 145TH ST
Second Line :
City : ORLAND PARK
State : IL
Zip : 60462-2840
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5841 S MARYLAND AVE
Second Line : MC 1081
City : CHICAGO
State : IL
Zip : 60637-1447
Country : US
Telephone Number : 773-702-6286
Fax Number : 773-702-5340
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2007
Last Update Date : 07/08/2007

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