MEDICARE: INFINITY REHAB OF MI 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
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1467315606
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INFINITY REHAB OF MI LLC

Provider Business Mailing Address
First Line	:	2935 SOUTHFIELD RD
Second Line	:
City	:	LATHRUP VILLAGE
State	:	MI
Zip	:	48076
Country	:	US
Telephone Number	:	248-882-0794
Fax Number	:

Provider Business Practice Location Address
First Line	:	28935 SOUTHFIELD RD
Second Line	:
City	:	LATHRUP VILLAGE
State	:	MI
Zip	:	48076-2720
Country	:	US
Telephone Number	:	248-882-0794
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	JORDAN DEHKO
Credential	:
Telephone Number	:	248-882-0794

Provider Enumeration Date	:	12/04/2025
Last Update Date	:	12/04/2025

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