Provider Demographics
NPI:1184641953
Name:REHAB ASSOCIATES OF CHICAGO, SC
Entity Type:Organization
Organization Name:REHAB ASSOCIATES OF CHICAGO, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-598-3527
Mailing Address - Street 1:PO BOX 83
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46308-0083
Mailing Address - Country:US
Mailing Address - Phone:219-333-0084
Mailing Address - Fax:
Practice Address - Street 1:850 S. WABASH STREET
Practice Address - Street 2:STE. 210
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-1209
Practice Address - Country:US
Practice Address - Phone:312-598-3527
Practice Address - Fax:224-242-9002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1633786OtherBLUE SHIELD
IL1633786OtherBLUE SHIELD