Provider Demographics
NPI:1467443127
Name:TEAM REHAB, INC.
Entity Type:Organization
Organization Name:TEAM REHAB, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MASSE'
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-355-7157
Mailing Address - Street 1:9450 N 107TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53224-1106
Mailing Address - Country:US
Mailing Address - Phone:414-355-7157
Mailing Address - Fax:414-355-7935
Practice Address - Street 1:9450 N 107TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53224-1106
Practice Address - Country:US
Practice Address - Phone:414-355-7157
Practice Address - Fax:414-355-7935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI555715OtherDEAN HEALTH PLAN
WI41812700Medicaid
WI111002OtherHEALTH PARTNERS
WI=========004OtherTRICARE NORTH
WI=========011OtherBLUE CROSS
WI555715OtherDEAN HEALTH PLAN
WI=========-COtherHIRSP
WI111002OtherHEALTH PARTNERS
WI=========0002OtherCIGNA
WI=========003OtherTRICARE NORTH
WIE00=========OtherAETNA
WI=========004OtherTRICARE NORTH