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General NPI Number Information
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NPI Number | 1013960665
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Entity Type | Organization
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Legal Business Name | AZER REHAB SYSTEMS, P.C.
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 09/04/2009
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Provider Practice Location Address
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Address Line | 872 W DAYTON ST
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City | GALESBURG
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State | IL
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Zip | 61401-1503
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Country | US
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Telephone | 309-344-3400
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Fax | 309-344-5040
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Provider Business Mailing Address
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Address Line | 872 W DAYTON ST
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City | GALESBURG
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State | IL
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Zip | 61401-1503
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Country | US
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Telephone | 309-344-3400
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Fax | 309-344-5040
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MRS. JULIE LYTLE
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Credential |
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Telephone | 309-344-3400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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