Healthcare Provider Details

I. General information

NPI: 1538687488
Provider Name (Legal Business Name): VERTEX REHABILITATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7603 N NORA AVE
NILES IL
60714-4728
US

IV. Provider business mailing address

7603 N NORA AVE
NILES IL
60714-4728
US

V. Phone/Fax

Practice location:
  • Phone: 847-962-2842
  • Fax:
Mailing address:
  • Phone: 847-962-2842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070014130
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number160006266
License Number StateIL

VIII. Authorized Official

Name: MARC ESPIRITU
Title or Position: PRESIDENT
Credential: PT
Phone: 773-983-2864