Provider Demographics
NPI:1356866958
Name:INTEGRAL MEDICAL & REHABILITATION, S.C
Entity Type:Organization
Organization Name:INTEGRAL MEDICAL & REHABILITATION, S.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:HARTLETT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:224-424-3147
Mailing Address - Street 1:3 W HAWTHORN PKWY STE 280
Mailing Address - Street 2:
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1446
Mailing Address - Country:US
Mailing Address - Phone:224-424-3147
Mailing Address - Fax:224-304-0256
Practice Address - Street 1:399 GLEN BYRN CT
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60194
Practice Address - Country:US
Practice Address - Phone:815-404-3064
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL38.011277111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty