Healthcare Provider Details

I. General information

NPI: 1437600632
Provider Name (Legal Business Name): CHICAGO REHABILITATION CONSULTANTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2016
Last Update Date: 02/25/2023
Certification Date: 02/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7156 W 127TH ST # 300
PALOS HEIGHTS IL
60463-1560
US

IV. Provider business mailing address

PO BOX 1109
CROWN POINT IN
46308-1109
US

V. Phone/Fax

Practice location:
  • Phone: 708-480-2650
  • Fax: 708-575-2876
Mailing address:
  • Phone: 708-480-2650
  • Fax: 708-575-2876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: AHMED H ELGAMAL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 847-917-1706