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General NPI Number Information
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NPI Number | 1871803205
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Entity Type | Organization
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Legal Business Name | ADVANCE REHAB NETWORK, INC.
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Dates
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Enumeration Date | 10/19/2010
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Last Update Date | 10/19/2010
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Provider Practice Location Address
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Address Line | 1240 IROQUOIS AVE SUITE 500
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City | NAPERVILLE
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State | IL
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Zip | 60563-8536
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Country | US
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Telephone | 630-717-9100
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Fax | 630-717-6300
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Provider Business Mailing Address
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Address Line | 1240 IROQUOIS AVE SUITE 500
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City | NAPERVILLE
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State | IL
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Zip | 60563-8536
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Country | US
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Telephone | 630-717-9100
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Fax | 630-717-6300
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Authorized Official
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Title or Position | DIRECTOR OF CLINICAL SERVICES
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Name | MR. ROBERTO VON ALCEDO
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Credential | BSN, RN
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Telephone | 630-717-9100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | IL1011198
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License Number State | IL
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