Provider Demographics
NPI:1467616987
Name:MILDER AND ASSOCIATES
Entity Type:Organization
Organization Name:MILDER AND ASSOCIATES
Other - Org Name:BARTLETT PHYSICAL THERAPY
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:MILDER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:630-483-7601
Mailing Address - Street 1:700 S BARTLETT RD
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:IL
Mailing Address - Zip Code:60103-4607
Mailing Address - Country:US
Mailing Address - Phone:630-483-7601
Mailing Address - Fax:630-483-7801
Practice Address - Street 1:700 S BARTLETT RD
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:IL
Practice Address - Zip Code:60103-4607
Practice Address - Country:US
Practice Address - Phone:630-483-7601
Practice Address - Fax:630-483-7801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-0026002251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK25555Medicare PIN
K25555Medicare PIN