Healthcare Provider Details

I. General information

NPI: 1922190610
Provider Name (Legal Business Name): DONALD S RIMBO PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 10/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 STATE ST
LEMONT IL
60439-4489
US

IV. Provider business mailing address

790 REMINGTON BLVD
BOLINGBROOK IL
60440-4909
US

V. Phone/Fax

Practice location:
  • Phone: 630-296-3103
  • Fax: 630-243-1203
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070013018
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: