Healthcare Provider Details

I. General information

NPI: 1659527273
Provider Name (Legal Business Name): OMEGA REHABILITATION SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2008
Last Update Date: 08/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3505 BLUFF RD
SPRINGFIELD IL
62711-7954
US

IV. Provider business mailing address

3505 BLUFF RD
SPRINGFIELD IL
62711-7954
US

V. Phone/Fax

Practice location:
  • Phone: 217-787-6802
  • Fax: 217-726-5297
Mailing address:
  • Phone: 217-787-6802
  • Fax: 217-726-5297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MARSHA BABINGTON
Title or Position: MANAGING MEMBER
Credential:
Phone: 217-787-6802