Healthcare Provider Details

I. General information

NPI: 1578573119
Provider Name (Legal Business Name): CHOICE REHAB INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 09/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

828 DAVIS ST STE 200
EVANSTON IL
60201-4442
US

IV. Provider business mailing address

828 DAVIS ST STE 200
EVANSTON IL
60201-4442
US

V. Phone/Fax

Practice location:
  • Phone: 847-328-1205
  • Fax: 847-424-1630
Mailing address:
  • Phone: 847-328-1205
  • Fax: 847-424-1630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: CHRISTIAN EGWUNWOKE
Title or Position: PRESIDENT
Credential:
Phone: 847-328-1205