Jamie McMillin
Individual provider Active NPI Physical Therapist · Geneseo, IL
NPI 1083063192 · NPPES record last updated Jun 9, 2016
Key facts
- NPI
- 1083063192
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 070.051095 (IL)
- Practice address
- 704 S Illinois St
Geneseo, IL 61254-1782 - Phone
- (309) 944-3072
- NPI assigned
- Jun 9, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070.051095 | IL | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070.051095 | IL | Yes |
Addresses
Primary practice location
704 S Illinois St
Geneseo, IL 61254-1782
Mailing address
704 S Illinois St
Geneseo, IL 61254-1782
Phone (309) 944-3072
Other providers in Geneseo, IL
- Maple Leaf Medical Services, LLC
- William P. Markovich
- Chad Richard Martens
- Richard Joseph McClimon
- Owen James McConnell
- Midwest Massage Therapy & Wellness Center LLC
- Lora Michelle Miner
- Rhonda Lynn Misfeldt
- David L Nelson
- Thuy Tien H Nguyen
All providers in Geneseo, IL · Physical Therapist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 9, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.