Provider First Line Business Practice Location Address: 
701 W NORTH AVE
    Provider Second Line Business Practice Location Address: 
REHAB SERVICES/THERAPY
    Provider Business Practice Location Address City Name: 
MELROSE PARK
    Provider Business Practice Location Address State Name: 
IL
    Provider Business Practice Location Address Postal Code: 
60160-1612
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
708-681-3200
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
09/25/2009