Healthcare Provider Details

I. General information

NPI: 1720292071
Provider Name (Legal Business Name): REHABILITATION INSTITUTE OF CHICAGO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 E SUPERIOR ST
CHICAGO IL
60611-2654
US

IV. Provider business mailing address

345 E SUPERIOR ST
CHICAGO IL
60611-2654
US

V. Phone/Fax

Practice location:
  • Phone: 312-238-4088
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number
License Number StateIL

VIII. Authorized Official

Name: MISS JILL M LANDRY
Title or Position: PHYSICAL THERAPIST
Credential: P.T, M.S.
Phone: 312-238-4088