Provider Demographics
NPI:1174694624
Name:MILDER, JAMES C (PT,)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:C
Last Name:MILDER
Suffix:
Gender:M
Credentials:PT,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27W132 CHURCHILL RD
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190-1089
Mailing Address - Country:US
Mailing Address - Phone:630-690-1489
Mailing Address - Fax:630-665-7940
Practice Address - Street 1:700 S BARTLETT RD
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:IL
Practice Address - Zip Code:60103-4607
Practice Address - Country:US
Practice Address - Phone:630-483-7601
Practice Address - Fax:630-483-7801
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X, 2251E1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251E1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistErgonomics
Provider Identifiers
StateIdentifier IDID TypeIssuer
K25555Medicare ID - Type Unspecified