Provider Demographics
NPI:1235536012
Name:ACCELERATED REHABILITATION SYSTEMS
Entity Type:Organization
Organization Name:ACCELERATED REHABILITATION SYSTEMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ATHLETIC TRAINER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHEVON
Authorized Official - Middle Name:
Authorized Official - Last Name:MALTBIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-676-7692
Mailing Address - Street 1:2002 89TH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53143-6736
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:205 W WACKER DR
Practice Address - Street 2:SUITE 1020
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60606-1216
Practice Address - Country:US
Practice Address - Phone:312-640-0329
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-22
Last Update Date:2014-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0960027372255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Single Specialty