Healthcare Provider Details

I. General information

NPI: 1396038568
Provider Name (Legal Business Name): EG REHAB SOLUTIONS,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2011
Last Update Date: 07/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5620 WYNRIDGE CT
INDIANAPOLIS IN
46235-7238
US

IV. Provider business mailing address

5620 WYNRIDGE CT
INDIANAPOLIS IN
46235-7238
US

V. Phone/Fax

Practice location:
  • Phone: 317-698-2130
  • Fax: 317-823-0662
Mailing address:
  • Phone: 317-698-2130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number05003853A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code2251E1200X
TaxonomyErgonomics Physical Therapist
License Number05003853A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code2251E1300X
TaxonomyClinical Electrophysiology Physical Therapist
License Number05003853A
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number5003853A
License Number StateIN
# 5
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number05003853A
License Number StateIN
# 6
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number05003853A
License Number StateIN
# 7
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number05003853A
License Number StateIN
# 8
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number05003853A
License Number StateIN
# 9
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number5003853A
License Number StateIN
# 10
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number05003853A
License Number StateIN

VIII. Authorized Official

Name: MRS. EILEEN APOSTOL BURNS
Title or Position: PRESIDENT/OWNER
Credential: PT
Phone: 317-698-2130