Provider Demographics
NPI:1093860421
Name:REHABILITATION MEDICINE ASSOCIATES PC
Entity Type:Organization
Organization Name:REHABILITATION MEDICINE ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PADMAJA
Authorized Official - Middle Name:
Authorized Official - Last Name:NEELAVENI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-836-6422
Mailing Address - Street 1:777 OAKMONT LN
Mailing Address - Street 2:SUITE 1600
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-5511
Mailing Address - Country:US
Mailing Address - Phone:630-789-2550
Mailing Address - Fax:
Practice Address - Street 1:8840 CALUMET AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2529
Practice Address - Country:US
Practice Address - Phone:219-836-6422
Practice Address - Fax:219-836-7245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000327090OtherANTHEM
DB9159OtherRAILROAD MEDICARE
IN000000327090OtherBCBS
IN000000327090OtherIN COMPREHENSIVE INSURANC
IN000000327090OtherIN COMPREHENSIVE INSURANC
IN000000327090OtherBCBS