Healthcare Provider Details

I. General information

NPI: 1164011235
Provider Name (Legal Business Name): BTD REHAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2021
Last Update Date: 01/13/2021
Certification Date: 01/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 ESSINGTON ROAD
JOLIET IL
60435-2869
US

IV. Provider business mailing address

301 WEST GRAND AVE SUITE 367
CHICAGO IL
60654-4640
US

V. Phone/Fax

Practice location:
  • Phone: 773-585-5900
  • Fax: 773-904-4302
Mailing address:
  • Phone: 773-585-5900
  • Fax: 773-904-4302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: IAN R BELTON
Title or Position: VP
Credential: DC
Phone: 760-271-6872