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General NPI Number Information
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NPI Number | 1417092321
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Entity Type | Organization
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Legal Business Name | REHABILITATION INSTITUTE OF CHICAGO
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 307 W GRAND AVE
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City | CHICAGO
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State | IL
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Zip | 60610-4140
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Country | US
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Telephone | 312-238-6850
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Fax |
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Provider Business Mailing Address
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Address Line | 307 W GRAND AVE
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City | CHICAGO
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State | IL
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Zip | 60610-4140
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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 | CLINICAL MANAGER
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Name | COLLEEN RADER
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Credential |
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Telephone | 312-238-6850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State | IL
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