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NPI Code Detail

MEDICARE: ENVISION CARE THERAPY INC

MEDICARE: ENVISION CARE THERAPY INC
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
1208100000XPhysical Medicine & Rehabilitation Physician

General Provider Information

NPI Number : 1497395933
Entity Type Code : Organization
Provider Name (Legal Business Name) : ENVISION CARE THERAPY INC
Provider Business Mailing Address
First Line : 912 PRAGUE AVE
Second Line :
City : BUFFALO GROVE
State : IL
Zip : 60089-2877
Country : US
Telephone Number : 224-805-9690
Fax Number :
Provider Business Practice Location Address
First Line : 1535 LAKE COOK RD STE 306
Second Line :
City : NORTHBROOK
State : IL
Zip : 60062-1452
Country : US
Telephone Number : 224-805-9690
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : BLESSON VARGHESE
Credential :
Telephone Number : 224-522-6550
Provider Enumeration Date : 01/13/2020
Last Update Date : 04/21/2020

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Directions to “ENVISION CARE THERAPY INC ” Practice Location

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