Provider Demographics
NPI:1740604552
Name:MUELLER, BRITTANY R (PTA)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:R
Last Name:MUELLER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18430 ZURICH LN
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-4399
Mailing Address - Country:US
Mailing Address - Phone:618-534-8098
Mailing Address - Fax:
Practice Address - Street 1:18430 ZURICH LN
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-4399
Practice Address - Country:US
Practice Address - Phone:618-534-8098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-13
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL160.005205225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant