Provider Demographics
NPI:1477508307
Name:UNITED REHAB PROVIDERS P.C
Entity Type:Organization
Organization Name:UNITED REHAB PROVIDERS P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHISICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-952-1052
Mailing Address - Street 1:6060 W 95TH ST
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2778
Mailing Address - Country:US
Mailing Address - Phone:708-952-1052
Mailing Address - Fax:708-952-1053
Practice Address - Street 1:6060 W 95TH ST
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2778
Practice Address - Country:US
Practice Address - Phone:708-952-1052
Practice Address - Fax:708-952-1053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day CareGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL738510Medicare ID - Type Unspecified