Healthcare Provider Details

I. General information

NPI: 1477508307
Provider Name (Legal Business Name): UNITED REHAB PROVIDERS P.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 04/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6060 W 95TH ST
OAK LAWN IL
60453-2778
US

IV. Provider business mailing address

6060 W 95TH ST
OAK LAWN IL
60453-2778
US

V. Phone/Fax

Practice location:
  • Phone: 708-952-1052
  • Fax: 708-952-1053
Mailing address:
  • Phone: 708-952-1052
  • Fax: 708-952-1053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: AHMED MOHAMED
Title or Position: PHISICAL THERAPIST
Credential:
Phone: 708-952-1052