| Organization Name: | MINDCARE PHYSICAL MEDICINE & REHAB CLINIC, INC. |
| NPI Number: | 1235257460 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GEORGE UDOETUK (ADMINISTRATOR) |
| Mailing Address: | 1010 Dixie Hwy Ste 308 Chicago Heights |
| State: | IL US |
| Postal Code: | 604112666 |
| Phone Number: | 7087561775 |
| Fax Number: | 7087561780 |
| NPI Enumeration Date: | 03/26/2007 |
| NPI Last Update Date: | 04/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 171W00000X |
| License Number: | =========001 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Contractor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering). |