MEDICARE: AMERICAN REHAB GROUP INC.

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
1	261QR0401X	Comprehensive Outpatient Rehabilitation Facility (CORF)

General Provider Information

NPI Number	:	1457612939
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN REHAB GROUP INC.

Provider Business Mailing Address
First Line	:	819 FARM DR
Second Line	:
City	:	WEST CHICAGO
State	:	IL
Zip	:	60185-4948
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1996 FRANCISCAN WAY
Second Line	:
City	:	WEST CHICAGO
State	:	IL
Zip	:	60185-6232
Country	:	US
Telephone Number	:	630-532-3697
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LUCIA VALLEJO
Credential	:
Telephone Number	:	630-532-3697

Provider Enumeration Date	:	05/31/2012
Last Update Date	:	05/31/2012

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