Provider Demographics
NPI:1033512017
Name:REHAB IN ACTION, LLC
Entity Type:Organization
Organization Name:REHAB IN ACTION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOWDHRY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:314-317-5803
Mailing Address - Street 1:PO BOX 50037
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63105-5037
Mailing Address - Country:US
Mailing Address - Phone:314-317-5803
Mailing Address - Fax:314-317-5948
Practice Address - Street 1:14709 OLIVE BLVD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-2221
Practice Address - Country:US
Practice Address - Phone:314-317-5803
Practice Address - Fax:314-317-5948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-03
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1215108337Medicaid
MOMA5254Medicare PIN