Healthcare Provider Details

I. General information

NPI: 1538805528
Provider Name (Legal Business Name): NEUROREHAB CONSULTANTS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2022
Last Update Date: 05/21/2024
Certification Date: 05/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 NORTH ARLINGTON HEIGHTS ROAD
ARLINGTON HEIGHTS IL
60004
US

IV. Provider business mailing address

PO BOX 266
LOCKPORT IL
60441-0266
US

V. Phone/Fax

Practice location:
  • Phone: 312-890-0637
  • Fax:
Mailing address:
  • Phone: 312-890-0637
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2081P0301X
TaxonomyBrain Injury Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID L RIPLEY
Title or Position: PRESIDENT/CEO
Credential: MD
Phone: 312-890-0637