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General NPI Number Information
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NPI Number | 1083771216
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Entity Type | Organization
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Legal Business Name | REHABILITATION ASSOCIATES OF NORTHERN
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6116 MULFORD VILLAGE DR
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City | ROCKFORD
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State | IL
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Zip | 61107-6657
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Country | US
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Telephone | 815-398-7264
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Fax | 815-229-7264
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Provider Business Mailing Address
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Address Line | 6116 MULFORD VILLAGE DR
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City | ROCKFORD
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State | IL
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Zip | 61107-6657
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Country | US
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Telephone | 815-398-7264
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Fax | 815-229-7264
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Authorized Official
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Title or Position | OWNER
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Name | KARL J. KLOSOWSKI
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Credential | D.C.
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Telephone | 814-398-7264
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State | IL
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