Provider Demographics
NPI:1801076997
Name:MILOSEVIC, EDITH (MPT)
Entity type:Individual
Prefix:
First Name:EDITH
Middle Name:
Last Name:MILOSEVIC
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8269 W GOLF RD
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-1156
Mailing Address - Country:US
Mailing Address - Phone:847-299-7000
Mailing Address - Fax:847-299-7007
Practice Address - Street 1:8269 W GOLF RD
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-1156
Practice Address - Country:US
Practice Address - Phone:847-299-7000
Practice Address - Fax:847-299-7007
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-06
Last Update Date:2009-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070016022225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist