Provider Demographics
NPI:1144379215
Name:MILLS, RUTH ANN (CHIROPRACTOR)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:ANN
Last Name:MILLS
Suffix:
Gender:F
Credentials:CHIROPRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2060 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-1780
Mailing Address - Country:US
Mailing Address - Phone:708-798-5625
Mailing Address - Fax:708-798-6025
Practice Address - Street 1:2060 RIDGE RD
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-1780
Practice Address - Country:US
Practice Address - Phone:708-798-5625
Practice Address - Fax:708-798-6025
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILU93739Medicare UPIN