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General NPI Number Information
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NPI Number | 1144450743
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Entity Type | Organization
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Legal Business Name | KENNETIC REHAB SERVICES, INC
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Dates
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Enumeration Date | 07/17/2009
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Last Update Date | 07/17/2009
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Provider Practice Location Address
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Address Line | 1043 CURTISS ST STE 4
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-4660
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Country | US
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Telephone | 630-964-4008
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Fax | 773-767-3944
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Provider Business Mailing Address
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Address Line | 5801 BLACKSTONE AVE
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City | LA GRANGE HIGHLANDS
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State | IL
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Zip | 60525-7108
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Country | US
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Telephone | 630-964-4008
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Fax | 773-767-3944
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Authorized Official
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Title or Position | BILLING COORDINATOR
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Name | LYNNETTE MCROY
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Credential |
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Telephone | 773-767-3822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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