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General NPI Number Information
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NPI Number | 1336497940
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Entity Type | Organization
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Legal Business Name | ALPHA REHAB CENTER, SC
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Dates
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Enumeration Date | 08/29/2012
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Last Update Date | 05/25/2021
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Provider Practice Location Address
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Address Line | 3253 HARLEM AVE SUITE 3
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City | BERWYN
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State | IL
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Zip | 60402-2996
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Country | US
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Telephone | 708-317-5553
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Fax | 708-788-4757
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Provider Business Mailing Address
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Address Line | 3253 HARLEM AVE SUITE 3
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City | BERWYN
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State | IL
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Zip | 60402-2996
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Country | US
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Telephone | 708-317-5553
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Fax | 708-788-4757
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ASHISH SUD
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Credential | DC
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Telephone | 708-317-5553
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 038010321
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License Number State | IL
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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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Taxonomy #3
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 038010456
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License Number State | IL
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