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General NPI Number Information
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NPI Number | 1417066481
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Entity Type | Organization
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Legal Business Name | METRO REHABILITATION SERVICES LTD
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 02/06/2012
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Provider Practice Location Address
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Address Line | 5320 159TH ST STE. 300
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City | OAK FOREST
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State | IL
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Zip | 60452-4705
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Country | US
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Telephone | 708-687-4747
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Fax | 708-687-4749
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Provider Business Mailing Address
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Address Line | 5320 159TH ST STE. 300
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City | OAK FOREST
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State | IL
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Zip | 60452-4705
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Country | US
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Telephone | 708-687-4747
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Fax | 708-687-4749
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Authorized Official
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Title or Position | THERAPIST/ PRESIDENT
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Name | MR. ABRAHAM JACOB
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Credential | RPT
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Telephone | 708-687-4747
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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 | 070005251
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License Number State | IL
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