MEDICARE: REHAB CARE

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	320700000X	Physical Disabilities Residential Treatment Facility	146005881	IL

General Provider Information

NPI Number	:	1912394354
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REHAB CARE

Provider Business Mailing Address
First Line	:	5112 JOHNSON AVE
Second Line	:
City	:	WESTERN SPRINGS
State	:	IL
Zip	:	60558-1913
Country	:	US
Telephone Number	:	708-772-8005
Fax Number	:

Provider Business Practice Location Address
First Line	:	5112 JOHNSON AVE
Second Line	:
City	:	WESTERN SPRINGS
State	:	IL
Zip	:	60558-1913
Country	:	US
Telephone Number	:	708-772-8005
Fax Number	:

Authorized Official
Title or Position	:	SPEECH-LANGUAGE PATHOLOGIST
Name	:	MRS. STACY FALLS
Credential	:
Telephone Number	:	708-772-8005

Provider Enumeration Date	:	04/23/2015
Last Update Date	:	04/23/2015

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Directions to “REHAB CARE ” Practice Location

Language	Start Address	Practice Location

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