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General NPI Number Information
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NPI Number | 1659605814
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Entity Type | Organization
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Legal Business Name | ELMHURST REHABILITATION SERVICES, P.C.
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Dates
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Enumeration Date | 09/21/2009
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Last Update Date | 09/21/2009
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Provider Practice Location Address
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Address Line | 360 W BUTTERFIELD RD STE 150
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City | ELMHURST
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State | IL
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Zip | 60126-5099
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Country | US
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Telephone | 630-834-0269
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Fax |
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Provider Business Mailing Address
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Address Line | 360 W BUTTERFIELD RD STE 150
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City | ELMHURST
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State | IL
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Zip | 60126-5099
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Country | US
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Telephone | 630-834-0269
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. DANIEL LEONARD HANSEN
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Credential | P.T.
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Telephone | 630-236-6861
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273Y00000X
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Taxonomy Name | Rehabilitation Hospital Unit
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License Number | 070011483
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License Number State | IL
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