Healthcare Provider Details

I. General information

NPI: 1013154335
Provider Name (Legal Business Name): NEWSOME REHABILITATION CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2009
Last Update Date: 01/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 ESSINGTON ROAD
JOLIET IL
60435
US

IV. Provider business mailing address

920 ESSINGTON ROAD
JOLIET IL
60435
US

V. Phone/Fax

Practice location:
  • Phone: 815-744-4770
  • Fax: 815-744-1845
Mailing address:
  • Phone: 815-744-4770
  • Fax: 815-744-1845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: DONNA S HATZL
Title or Position: BILLING/COLLECTION SUPERVISOR
Credential:
Phone: 815-744-4770