Provider Demographics
NPI:1922164243
Name:LIN-MILLMAN, FANG-LING (MS, OTRL)
Entity Type:Individual
Prefix:
First Name:FANG-LING
Middle Name:
Last Name:LIN-MILLMAN
Suffix:
Gender:F
Credentials:MS, OTRL
Other - Prefix:
Other - First Name:FANG-LING
Other - Middle Name:
Other - Last Name:LIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, OTRL
Mailing Address - Street 1:3551 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-2100
Mailing Address - Country:US
Mailing Address - Phone:630-275-2600
Mailing Address - Fax:630-275-2698
Practice Address - Street 1:3551 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-2100
Practice Address - Country:US
Practice Address - Phone:630-275-2600
Practice Address - Fax:630-275-2698
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.003427225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist