Provider Demographics
NPI:1073055026
Name:PHYSICAL REHABILITATION CLINICS INC.
Entity Type:Organization
Organization Name:PHYSICAL REHABILITATION CLINICS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSEN
Authorized Official - Middle Name:GERALD
Authorized Official - Last Name:GAVINO
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:630-989-5449
Mailing Address - Street 1:17 W 574 HALSEY RD.
Mailing Address - Street 2:
Mailing Address - City:OAKBROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181
Mailing Address - Country:US
Mailing Address - Phone:630-989-5449
Mailing Address - Fax:
Practice Address - Street 1:1883 SUITE C HICKS RD
Practice Address - Street 2:
Practice Address - City:ROLLING MEADOWS
Practice Address - State:IL
Practice Address - Zip Code:60008
Practice Address - Country:US
Practice Address - Phone:630-989-5449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-08
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070014676225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty