Healthcare Provider Details

I. General information

NPI: 1518059336
Provider Name (Legal Business Name): REHABILITY SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 W CHICAGO AVE RIVERWALK #4
CHICAGO IL
60610
US

IV. Provider business mailing address

600 W CHICAGO AVE RIVERWALK #4
CHICAGO IL
60610
US

V. Phone/Fax

Practice location:
  • Phone: 312-644-4500
  • Fax: 312-644-4501
Mailing address:
  • Phone: 312-644-4500
  • Fax: 312-644-4501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number70013088
License Number StateIL

VIII. Authorized Official

Name: MS. TYRA ISBELL
Title or Position: CONTRACTOR
Credential:
Phone: 312-415-0344