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NPI Code Detail

MEDICARE: INTEGRATED REHAB CONSULTANTS LLC

MEDICARE: INTEGRATED REHAB CONSULTANTS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208100000XPhysical Medicine & Rehabilitation Physician

General Provider Information

NPI Number : 1104643022
Entity Type Code : Organization
Provider Name (Legal Business Name) : INTEGRATED REHAB CONSULTANTS LLC
Provider Business Mailing Address
First Line : PO BOX 74008272
Second Line :
City : CHICAGO
State : IL
Zip : 60674-8272
Country : US
Telephone Number : 312-635-0973
Fax Number : 312-635-0050
Provider Business Practice Location Address
First Line : 12230 ROUNDWOOD RD
Second Line :
City : LUTHERVILLE TIMONIUM
State : MD
Zip : 21093-3233
Country : US
Telephone Number : 312-635-0973
Fax Number : 312-635-0050
Authorized Official
Title or Position : CEO
Name : AMISH MANU PATEL
Credential :
Telephone Number : 312-635-0973
Provider Enumeration Date : 09/23/2024
Last Update Date : 09/23/2024

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