Healthcare Provider Details

I. General information

NPI: 1265521959
Provider Name (Legal Business Name): MILESTONE REHABILITATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

474 PARKWOOD CIRCLE
SOUTH ELGIN IL
60177
US

IV. Provider business mailing address

474 PARKWOOD CIRCLE
SOUTH ELGIN IL
60177
US

V. Phone/Fax

Practice location:
  • Phone: 847-691-6516
  • Fax: 847-742-8419
Mailing address:
  • Phone: 847-691-6516
  • Fax: 847-742-8419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number
License Number StateIL

VIII. Authorized Official

Name: MRS. SHUBHRA ADITI MEHRA
Title or Position: OCCUPATIONAL THERAPIST OWNER
Credential: BSC OTRL
Phone: 847-691-6516