Healthcare Provider Details

I. General information

NPI: 1023062601
Provider Name (Legal Business Name): REHABILITATION MEDICINE CLINIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26W171 ROOSEVELT RD
WHEATON IL
60187-6078
US

IV. Provider business mailing address

26W171 ROOSEVELT RD
WHEATON IL
60187-6078
US

V. Phone/Fax

Practice location:
  • Phone: 630-588-7891
  • Fax: 630-462-5573
Mailing address:
  • Phone: 630-588-7891
  • Fax: 630-462-5573

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. DOMINIC MARTIN SERPICO JR.
Title or Position: DIRECTOR, FINANCE
Credential:
Phone: 630-588-7891