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General NPI Number Information
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NPI Number | 1104119684
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Entity Type | Organization
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Legal Business Name | PERFORMANCE IN MOTION REHABILITATION, INC
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Dates
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Enumeration Date | 05/17/2011
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Last Update Date | 05/17/2011
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Provider Practice Location Address
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Address Line | 820 N ORLEANS ST SUITE 100
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City | CHICAGO
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State | IL
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Zip | 60610-3132
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Country | US
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Telephone | 714-625-2026
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Fax |
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Provider Business Mailing Address
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Address Line | 353 E HUNTINGTON LN
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City | ELMHURST
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State | IL
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Zip | 60126-3652
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Country | US
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Telephone | 714-625-2026
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/PHYSICAL THERAPIST
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Name | MR. ROBERT SHIGEMI OHASHI
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Credential | PT, DPT, OCS, ATC
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Telephone | 714-625-2026
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 070.017711
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License Number State | IL
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