Provider Demographics
NPI:1083092175
Name:ARLINGTON HEIGHTS MEDICAL, SC
Entity Type:Organization
Organization Name:ARLINGTON HEIGHTS MEDICAL, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HUMAN RESOURCES MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:KITCHENMASTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-221-0200
Mailing Address - Street 1:1751 S NAPERVILLE RD
Mailing Address - Street 2:200
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60189-5896
Mailing Address - Country:US
Mailing Address - Phone:630-221-0200
Mailing Address - Fax:630-384-2240
Practice Address - Street 1:3115 N WILKE RD
Practice Address - Street 2:A & B
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-1400
Practice Address - Country:US
Practice Address - Phone:224-795-5700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-11
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070012166225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty