Provider Demographics
NPI:1245688795
Name:MILESTONES THERAPEUTIC SERVICES INC.
Entity type:Organization
Organization Name:MILESTONES THERAPEUTIC SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MYRNA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-550-7628
Mailing Address - Street 1:3430 W PALMER ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-3518
Mailing Address - Country:US
Mailing Address - Phone:773-550-7628
Mailing Address - Fax:773-394-0623
Practice Address - Street 1:3430 W PALMER ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-3518
Practice Address - Country:US
Practice Address - Phone:773-550-7628
Practice Address - Fax:773-394-0623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-25
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILMF40761102P222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Single Specialty