Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | IL | |
N | 2251E1200X | Ergonomics | IL | |
N | 225XE1200X | Ergonomics | IL |
NPI | 1174694624 |
---|---|
Provider Name | Mr. James C Milder |
First Address | Winfield, IL 60190-1089 |
Second Address | Bartlett, IL 60103-4607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 15/08/2007 |