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General NPI Number Information
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NPI Number | 1639308968
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Entity Type | Organization
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Legal Business Name | U.S. REHABILITATION SERVICE PC
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Dates
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Enumeration Date | 07/08/2009
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Last Update Date | 08/27/2013
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Provider Practice Location Address
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Address Line | 11012 S WESTERN AVE
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City | CHICAGO
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State | IL
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Zip | 60643-3928
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Country | US
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Telephone | 773-238-5300
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Fax | 773-238-5343
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Provider Business Mailing Address
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Address Line | 11012 S WESTERN AVE SUITE B
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City | CHICAGO
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State | IL
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Zip | 60643-3928
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Country | US
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Telephone | 773-238-5300
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Fax | 773-238-5343
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Authorized Official
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Title or Position | OWNER
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Name | MRS. GAIL PYE
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Credential | OWNER
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Telephone | 773-238-5300
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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 | 036093488
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License Number State | IL
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