Healthcare Provider Details

I. General information

NPI: 1053851618
Provider Name (Legal Business Name): SKILLED REHABILITATION SPECIALISTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2017
Last Update Date: 03/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1513 NORFOLK AVE
WESTCHESTER IL
60154-3737
US

IV. Provider business mailing address

1513 NORFOLK AVE
WESTCHESTER IL
60154-3737
US

V. Phone/Fax

Practice location:
  • Phone: 630-408-1117
  • Fax: 708-575-2876
Mailing address:
  • Phone: 630-408-1117
  • Fax: 708-575-2876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number036134581
License Number StateIL

VIII. Authorized Official

Name: BADER ALMOSHELLI
Title or Position: OWNER
Credential: M.D.
Phone: 630-408-1117