Provider Demographics
NPI:1376872911
Name:NORTH SUBURBAN THERAPY, INC.
Entity Type:Organization
Organization Name:NORTH SUBURBAN THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AKASH
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-489-5532
Mailing Address - Street 1:1480 RENAISSANCE DR
Mailing Address - Street 2:SUITE 304
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1332
Mailing Address - Country:US
Mailing Address - Phone:847-768-9240
Mailing Address - Fax:847-768-9304
Practice Address - Street 1:1480 RENAISSANCE DR
Practice Address - Street 2:SUITE 304
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1332
Practice Address - Country:US
Practice Address - Phone:847-768-9240
Practice Address - Fax:847-768-9304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-10
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL144519261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL144519Medicare Oscar/Certification