Provider Demographics
NPI:1578514741
Name:BELOCURA, MILALLY (PT)
Entity Type:Individual
Prefix:
First Name:MILALLY
Middle Name:
Last Name:BELOCURA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9633 RIDGELAND AVE APT 1D
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2751
Mailing Address - Country:US
Mailing Address - Phone:708-856-4285
Mailing Address - Fax:708-529-0123
Practice Address - Street 1:9633 RIDGELAND AVE APT 1D
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2751
Practice Address - Country:US
Practice Address - Phone:708-856-4285
Practice Address - Fax:708-529-0123
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist