Healthcare Provider Details

I. General information

NPI: 1669126835
Provider Name (Legal Business Name): OMEGA REHAB & MOBILITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2022
Last Update Date: 02/07/2022
Certification Date: 02/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 S ROHLWING RD
ADDISON IL
60101-3027
US

IV. Provider business mailing address

155 S ROHLWING RD
ADDISON IL
60101-3027
US

V. Phone/Fax

Practice location:
  • Phone: 630-414-1909
  • Fax: 630-797-5745
Mailing address:
  • Phone: 630-414-1909
  • Fax: 630-797-5745

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. JEYARAJ VALENTINE DAVID
Title or Position: REHAB & MOBILITY SPECIALIST
Credential: ATP
Phone: 630-414-1909