Provider Demographics
NPI:1053088732
Name:THE REHABILITATION INSTITUTE OF SOUTHERN ILLINOIS,LLC
Entity Type:Organization
Organization Name:THE REHABILITATION INSTITUTE OF SOUTHERN ILLINOIS,LLC
Other - Org Name:THE REHABILITATION INSTITUTE OF SOUTHERN ILLINOIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:WISNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-970-5702
Mailing Address - Street 1:2351 FRANK SCOTT PKWY E
Mailing Address - Street 2:
Mailing Address - City:SHILOH
Mailing Address - State:IL
Mailing Address - Zip Code:62269-7457
Mailing Address - Country:US
Mailing Address - Phone:618-206-7610
Mailing Address - Fax:618-206-7995
Practice Address - Street 1:2351 FRANK SCOTT PKWY E
Practice Address - Street 2:
Practice Address - City:SHILOH
Practice Address - State:IL
Practice Address - Zip Code:62269-7457
Practice Address - Country:US
Practice Address - Phone:618-206-7610
Practice Address - Fax:618-206-7995
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ENCOMPASS HEALTH CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-30
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital