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General NPI Number Information
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NPI Number | 1740377019
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Entity Type | Organization
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Legal Business Name | UNIVERSAL REHABILITATION SERVICES P.C.
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 03/29/2013
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Provider Practice Location Address
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Address Line | 9614 MERTON AVE
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City | OAK LAWN
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State | IL
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Zip | 60453-2705
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Country | US
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Telephone | 708-296-9771
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Fax |
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Provider Business Mailing Address
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Address Line | 9614 S MERTON AVE
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City | OAK LAWN
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State | IL
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Zip | 60453
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Country | US
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Telephone | 708-296-9771
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | HATEM KHATAB
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Credential |
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Telephone | 708-296-9771
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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 | 070-009068
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License Number State | IL
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