Provider Demographics
NPI:1437600632
Name:CHICAGO REHABILITATION CONSULTANTS LLC
Entity Type:Organization
Organization Name:CHICAGO REHABILITATION CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:H
Authorized Official - Last Name:ELGAMAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-917-1706
Mailing Address - Street 1:PO BOX 1109
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46308-1109
Mailing Address - Country:US
Mailing Address - Phone:708-480-2650
Mailing Address - Fax:708-575-2876
Practice Address - Street 1:7156 W 127TH ST # 300
Practice Address - Street 2:
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1560
Practice Address - Country:US
Practice Address - Phone:708-480-2650
Practice Address - Fax:708-575-2876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-22
Last Update Date:2023-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036112679Medicaid
IL036112679Medicaid
ILF100368069Medicare PIN