MEDICARE: MRS. HEATHER MILLIGAN OTR/L

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	225X00000X	Occupational Therapist	056008668	IL

General Provider Information

NPI Number	:	1932439478
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HEATHER MILLIGAN OTR/L

Provider Business Mailing Address
First Line	:	2326 W GIDDINGS ST
Second Line	:	#306
City	:	CHICAGO
State	:	IL
Zip	:	60625-8310
Country	:	US
Telephone Number	:	315-383-6665
Fax Number	:

Provider Business Practice Location Address
First Line	:	2326 W GIDDINGS ST
Second Line	:	#306
City	:	CHICAGO
State	:	IL
Zip	:	60625-8310
Country	:	US
Telephone Number	:	315-383-6665
Fax Number	:

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

Provider Enumeration Date	:	01/06/2010
Last Update Date	:	01/06/2010

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