Provider Demographics
NPI:1407054604
Name:RCI, (WRS, INC.)
Entity Type:Organization
Organization Name:RCI, (WRS, INC.)
Other - Org Name:NOVACARE OUTPATIENT REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:618-937-6200
Mailing Address - Street 1:502 W SAINT LOUIS ST STE 3
Mailing Address - Street 2:
Mailing Address - City:WEST FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:62896-1968
Mailing Address - Country:US
Mailing Address - Phone:618-937-6200
Mailing Address - Fax:
Practice Address - Street 1:502 W SAINT LOUIS ST
Practice Address - Street 2:STE 3
Practice Address - City:WEST FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:62896-1968
Practice Address - Country:US
Practice Address - Phone:618-937-6200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy