Healthcare Provider Details

I. General information

NPI: 1902953078
Provider Name (Legal Business Name): REHABILITATION INSTITUTE OF CHICAGO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 EAST SUPERIOR STREET
CHICAGO IL
60611
US

IV. Provider business mailing address

325 EAST SUPERIOR STREET
CHICAGO IL
60611
US

V. Phone/Fax

Practice location:
  • Phone: 312-238-2306
  • Fax:
Mailing address:
  • Phone: 312-238-8013
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number12466785
License Number StateIL

VIII. Authorized Official

Name: MR. ED CASE
Title or Position: CFO
Credential:
Phone: 312-238-2306