Provider Demographics
NPI:1275312274
Name:R3S LLC
Entity Type:Organization
Organization Name:R3S LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RUNALI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:608-628-4612
Mailing Address - Street 1:671 TACOMA DR
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-4743
Mailing Address - Country:US
Mailing Address - Phone:608-628-4612
Mailing Address - Fax:
Practice Address - Street 1:2401 KANEVILLE RD STE 5
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-2577
Practice Address - Country:US
Practice Address - Phone:608-628-4612
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-27
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy