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General NPI Number Information
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NPI Number | 1366330193
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Entity Type | Organization
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Legal Business Name | TRUNK REHAB LLC
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Dates
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Enumeration Date | 06/27/2025
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 3717 N RAVENSWOOD AVE STE 110
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City | CHICAGO
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State | IL
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Zip | 60613-3880
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Country | US
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Telephone | 773-600-4990
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Fax |
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Provider Business Mailing Address
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Address Line | 3660 N LAKE SHORE DR APT 4010
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City | CHICAGO
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State | IL
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Zip | 60613-5317
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | CRIS ASPERA
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Credential |
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Telephone | 773-600-4990
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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 |
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