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General NPI Number Information
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NPI Number | 1114086543
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Entity Type | Organization
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Legal Business Name | DUPAGE REHABILITATION, INC.
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 11/01/2007
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Provider Practice Location Address
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Address Line | 10 W MARTIN AVE STE 226
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City | NAPERVILLE
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State | IL
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Zip | 60540-6590
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Country | US
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Telephone | 630-848-1744
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Fax | 630-848-1745
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Provider Business Mailing Address
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Address Line | 10 W MARTIN AVE STE 226
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City | NAPERVILLE
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State | IL
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Zip | 60540-6590
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Country | US
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Telephone | 630-848-1744
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Fax | 630-848-1745
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Authorized Official
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Title or Position | OWNER
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Name | MRS. TABIA LEE EARL
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Credential | PT
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Telephone | 630-848-1744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State | IL
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