Provider Demographics
NPI:1073181756
Name:MILLER, AUSTIN GRANT (PT, DPT)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:GRANT
Last Name:MILLER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 735263
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-5263
Mailing Address - Country:US
Mailing Address - Phone:708-492-5350
Mailing Address - Fax:708-409-5179
Practice Address - Street 1:4400 MCCOY DR STE 114
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-4597
Practice Address - Country:US
Practice Address - Phone:708-492-5350
Practice Address - Fax:708-409-5179
Is Sole Proprietor?:No
Enumeration Date:2021-06-17
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070029278225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist