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General NPI Number Information
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NPI Number | 1699324095
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Entity Type | Organization
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Legal Business Name | REHABON LLC
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Dates
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Enumeration Date | 09/09/2019
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Last Update Date | 02/13/2020
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Provider Practice Location Address
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Address Line | 1226 OGDEN AVE
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-2740
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Country | US
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Telephone | 312-730-4593
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Fax |
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Provider Business Mailing Address
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Address Line | 216 S BODIN ST
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City | HINSDALE
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State | IL
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Zip | 60521-3913
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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 | PRESIDENT/PHYSICAL THERAPIST
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Name | IRFAN M IBRAHIM
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Credential | PT DPT
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Telephone | 312-730-4593
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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 |
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License Number State |
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