Healthcare Provider Details

I. General information

NPI: 1912124306
Provider Name (Legal Business Name): PROGRESSIVE HEALTH & REHABILITATION LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 08/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1283 W DUNDEE RD
BUFFALO GROVE IL
60089-4009
US

IV. Provider business mailing address

1283 W DUNDEE RD
BUFFALO GROVE IL
60089-4009
US

V. Phone/Fax

Practice location:
  • Phone: 847-632-9919
  • Fax: 847-632-9981
Mailing address:
  • Phone: 847-632-9919
  • Fax: 847-632-9981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number038.008505
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number042-618646
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number07012126
License Number StateIL
# 5
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number038-008505
License Number StateIL

VIII. Authorized Official

Name: DR. JASON HUI
Title or Position: OWNER
Credential: D.C.
Phone: 847-632-9919