Organization Name: | ADVANCED THERAPY& REHAB |
NPI Number: | 1386820165 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JENIFER CARLOS DE LARA (REGIONAL DIRECTOR OF THERAPY) |
Mailing Address: | 6400 Shafer Ct Suite 600 Rosemont |
State: | IL US |
Postal Code: | 600184914 |
Phone Number: | 8477208700 |
Fax Number: | |
NPI Enumeration Date: | 01/11/2008 |
NPI Last Update Date: | 01/11/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |