Provider Demographics
NPI:1447764618
Name:UC PAIN AND REHAB PC
Entity Type:Organization
Organization Name:UC PAIN AND REHAB PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:HANA
Authorized Official - Middle Name:I
Authorized Official - Last Name:SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:847-376-8540
Mailing Address - Street 1:1245 MILWAUKEE AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-2400
Mailing Address - Country:US
Mailing Address - Phone:847-376-8540
Mailing Address - Fax:847-376-8577
Practice Address - Street 1:1245 MILWAUKEE AVE STE 302
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-2400
Practice Address - Country:US
Practice Address - Phone:847-376-8540
Practice Address - Fax:847-376-8577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-27
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070018755208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1881977239OtherPHYSICAL THERAPIST