MEDICARE: CENTER FOR REHABILITATION TECHNOLOGY 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	:	1669695227
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTER FOR REHABILITATION TECHNOLOGY INC

Provider Business Mailing Address
First Line	:	64 S PRAIRIE ST
Second Line	:	218 WEINBERG ARCADE
City	:	GALESBURG
State	:	IL
Zip	:	61401-4642
Country	:	US
Telephone Number	:	309-342-6156
Fax Number	:	309-342-3714

Provider Business Practice Location Address
First Line	:	64 S PRAIRIE ST
Second Line	:	218 WEINBERG ARCADE
City	:	GALESBURG
State	:	IL
Zip	:	61401-4642
Country	:	US
Telephone Number	:	309-342-6156
Fax Number	:	309-342-3714

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. LOU ANN SMITH
Credential	:
Telephone Number	:	309-342-6156

Provider Enumeration Date	:	04/11/2007
Last Update Date	:	08/22/2020

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