MEDICARE: PF DEVELOPMENT 6 LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0400X	Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1073834958
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PF DEVELOPMENT 6 LLC

Provider Business Mailing Address
First Line	:	4058 W MELROSE ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60641-4799
Country	:	US
Telephone Number	:	773-736-7000
Fax Number	:	773-202-4355

Provider Business Practice Location Address
First Line	:	4058 W MELROSE ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60641-4799
Country	:	US
Telephone Number	:	773-736-7000
Fax Number	:	773-202-4355

Authorized Official
Title or Position	:	SR. VP OF REIMBURSEMENT
Name	:	MR. ARTHUR L. ROTHGERBER
Credential	:
Telephone Number	:	502-596-7300

Provider Enumeration Date	:	06/15/2010
Last Update Date	:	11/30/2010

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Directions to “PF DEVELOPMENT 6 LLC ” Practice Location

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