Healthcare Provider Details

I. General information

NPI: 1063557429
Provider Name (Legal Business Name): AUBURN PARK REHABILITATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

326 W 47TH ST
CHICAGO IL
60609-4501
US

IV. Provider business mailing address

326 W 47TH ST
CHICAGO IL
60609-4501
US

V. Phone/Fax

Practice location:
  • Phone: 773-224-1900
  • Fax: 773-224-1102
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. ROBERT HARMEYER
Title or Position: ADMINISTRATOR
Credential: D.C
Phone: 773-224-1900