Healthcare Provider Details

I. General information

NPI: 1629973656
Provider Name (Legal Business Name): MUSCLE MEMORY REHAB PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 E 22ND ST STE 115
LOMBARD IL
60148-6100
US

IV. Provider business mailing address

2 E 22ND ST STE 115
LOMBARD IL
60148-6100
US

V. Phone/Fax

Practice location:
  • Phone: 630-656-4665
  • Fax:
Mailing address:
  • Phone: 630-656-4665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. ASHHAD SHARIF
Title or Position: OWNER
Credential: DPT
Phone: 630-935-1963