Provider Demographics
NPI:1073989703
Name:REHABON INC
Entity Type:Organization
Organization Name:REHABON INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & CEO
Authorized Official - Prefix:
Authorized Official - First Name:IRFAN
Authorized Official - Middle Name:MEHMUD
Authorized Official - Last Name:IBRAHIM
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:312-730-4593
Mailing Address - Street 1:80 BRIDGE ST
Mailing Address - Street 2:207
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-1765
Mailing Address - Country:US
Mailing Address - Phone:312-730-4593
Mailing Address - Fax:
Practice Address - Street 1:4 BURNT BRIDGE RD
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:MA
Practice Address - Zip Code:02067-2991
Practice Address - Country:US
Practice Address - Phone:312-730-4593
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-17
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19060261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy