Provider Demographics
NPI:1053331447
Name:ACHIEVE ORTHOPEDIC REHABILITATION INSTITUTE,INC
Entity Type:Organization
Organization Name:ACHIEVE ORTHOPEDIC REHABILITATION INSTITUTE,INC
Other - Org Name:ACHIEVE ORTHOPEDIC REHAB
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ASHRAF
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDELHAMID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-497-9078
Mailing Address - Street 1:PO BOX 228
Mailing Address - Street 2:
Mailing Address - City:WILLOW SPRINGS
Mailing Address - State:IL
Mailing Address - Zip Code:60480-0228
Mailing Address - Country:US
Mailing Address - Phone:630-371-1623
Mailing Address - Fax:312-642-3966
Practice Address - Street 1:100 E WALTON ST
Practice Address - Street 2:SUITE 700
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-1448
Practice Address - Country:US
Practice Address - Phone:312-642-3963
Practice Address - Fax:312-642-3966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILDA4033OtherRR MEDICARE
ILDA4033OtherRR MEDICARE
IL204585Medicare PIN