MEDICARE: D K REHABILITATION SERVICES, 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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1891855581
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	D K REHABILITATION SERVICES, INC

Provider Business Mailing Address
First Line	:	9415 S WESTERN AVE STE 205
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60620-6232
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9415 S WESTERN AVE STE 205
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60620-6232
Country	:	US
Telephone Number	:	773-445-4550
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KHALIL MEMON
Credential	:
Telephone Number	:	773-298-9322

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	08/22/2020

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