Healthcare Provider Details

I. General information

NPI: 1053404640
Provider Name (Legal Business Name): COMMUNITY HEALTH & REHABILITATION, SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 10/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 W HIGGINS ROAD
HOFFMAN ESTATES IL
60169
US

IV. Provider business mailing address

275 W HIGGINS ROAD
HOFFMAN ESTATES IL
60169
US

V. Phone/Fax

Practice location:
  • Phone: 847-885-8820
  • Fax: 847-885-9578
Mailing address:
  • Phone: 847-885-8820
  • Fax: 847-885-9578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number042617415
License Number StateIL
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036-103275
License Number StateIL
# 5
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number1679510804
License Number StateIL

VIII. Authorized Official

Name: ANTHONY J PETRONE
Title or Position: CEO
Credential:
Phone: 847-885-8820