Provider Demographics
NPI:1750369567
Name:MILRUD, LINA (DC)
Entity type:Individual
Prefix:DR
First Name:LINA
Middle Name:
Last Name:MILRUD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 S ELIZABETH LN
Mailing Address - Street 2:
Mailing Address - City:ROUND LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60073-4291
Mailing Address - Country:US
Mailing Address - Phone:847-740-0825
Mailing Address - Fax:847-740-9215
Practice Address - Street 1:1829 S CEDAR LAKE RD
Practice Address - Street 2:
Practice Address - City:ROUND LAKE
Practice Address - State:IL
Practice Address - Zip Code:60073
Practice Address - Country:US
Practice Address - Phone:847-740-9200
Practice Address - Fax:847-740-9215
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
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
IL01628297OtherBCBSIL
IL10672531OtherCAQH ID
IL213848Medicare ID - Type UnspecifiedFROM 2006-05-01