Healthcare Provider Details

I. General information

NPI: 1427763507
Provider Name (Legal Business Name): TOTAL REHAB THERAPY PARTNERS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2023
Last Update Date: 03/12/2023
Certification Date: 03/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4920 N CENTRAL AVE STE 1A
CHICAGO IL
60630-2345
US

IV. Provider business mailing address

PO BOX 72180
ROSELLE IL
60172-0180
US

V. Phone/Fax

Practice location:
  • Phone: 773-701-8048
  • Fax: 630-924-0462
Mailing address:
  • Phone: 630-924-0156
  • Fax: 630-924-0462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: SCOTT WOLFF
Title or Position: CEO
Credential:
Phone: 773-559-5824