1659765709 NPI number — ACCELERATED REHABILITATION CENTERS, LTD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659765709 NPI number — ACCELERATED REHABILITATION CENTERS, LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACCELERATED REHABILITATION CENTERS, LTD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1659765709
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/27/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
625 ENTERPRISE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OAK BROOK
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60523-8813
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
630-575-6250
Provider Business Mailing Address Fax Number:
630-575-7450

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4700 GILBERT AVE
Provider Second Line Business Practice Location Address:
STE43A
Provider Business Practice Location Address City Name:
WESTERN SPRINGS
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60558-1753
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
708-783-1044
Provider Business Practice Location Address Fax Number:
708-783-1048
Provider Enumeration Date:
03/26/2015

Additional Information

Authorized Official

Authorized Official Last Name:
COOK
Authorized Official First Name:
GERI
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF CLINICAL SERVICES
Authorized Official Telephone Number:
630-575-1940

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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