Healthcare Provider Details

I. General information

NPI: 1316858384
Provider Name (Legal Business Name): SELECT REHABILITATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 NE PURCELL BLVD
BEND OR
97701-7316
US

IV. Provider business mailing address

2600 COMPASS RD
GLENVIEW IL
60026-8001
US

V. Phone/Fax

Practice location:
  • Phone: 541-385-8500
  • Fax: 847-386-5196
Mailing address:
  • Phone: 678-491-6692
  • Fax: 847-386-5196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: DENISE NICOLE DURHAM
Title or Position: VICE PRESIDENT
Credential: PT
Phone: 678-491-6692