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General NPI Number Information
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NPI Number | 1124809280
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Entity Type | Organization
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Legal Business Name | EZ SPINE AND JOINT REHAB INC.
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Dates
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Enumeration Date | 10/13/2023
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Last Update Date | 10/13/2023
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Provider Practice Location Address
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Address Line | 3524 MILWAUKEE AVE
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City | NORTHBROOK
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State | IL
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Zip | 60062-7130
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Country | US
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Telephone | 847-296-1600
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Fax | 224-361-3550
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Provider Business Mailing Address
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Address Line | 3524 MILWAUKEE AVE
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City | NORTHBROOK
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State | IL
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Zip | 60062-7130
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Country | US
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Telephone | 847-296-1600
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Fax | 224-361-3550
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HANSEOK OH
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Credential | DPT
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Telephone | 224-616-7021
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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 |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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