=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215806898
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | REHABCARE GROUP EAST, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/03/2025
-----------------------------------------------------
Last Update Date | 11/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5317 SPEEGLEVILLE RD
-----------------------------------------------------
City | WACO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76712-4020
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 254-272-5510
-----------------------------------------------------
Fax | 847-386-5196
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2600 COMPASS RD
-----------------------------------------------------
City | GLENVIEW
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60026-8001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 678-491-6692
-----------------------------------------------------
Fax | 847-386-5196
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VICE PRESIDENT
-----------------------------------------------------
Name | DENISE NICOLE DURHAM
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 678-491-6692
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208100000X
-----------------------------------------------------
Taxonomy Name | Physical Medicine & Rehabilitation Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------