Organization Name: | VITAL REHABILITATION & PHYSICAL THERAPY INC |
NPI Number: | 1194898114 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TOMASZ J KOKOCINSKI (PRESIDENT) |
Mailing Address: | 11600 S Kedzie Merrionette Park |
State: | IL US |
Postal Code: | 60803 |
Phone Number: | 7083716441 |
Fax Number: | 7083716429 |
NPI Enumeration Date: | 11/16/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0401X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
Taxonomy Definition: |