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General NPI Number Information
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NPI Number | 1528398690
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Entity Type | Organization
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Legal Business Name | ELITE REHAB SERVICES
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Dates
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Enumeration Date | 01/12/2010
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Last Update Date | 01/12/2010
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Provider Practice Location Address
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Address Line | 215 E 31ST ST
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City | CHICAGO
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State | IL
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Zip | 60616-4669
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Country | US
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Telephone | 312-415-4600
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Fax |
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Provider Business Mailing Address
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Address Line | 215 E 31ST ST
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City | CHICAGO
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State | IL
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Zip | 60616-4669
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Country | US
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Telephone | 312-415-4600
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | MRS. MARIE INEZ WEBSTER-WEAVER
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Credential | DPT
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Telephone | 312-415-4600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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