Provider Demographics
NPI:1477942449
Name:MEDCARE INC.
Entity Type:Organization
Organization Name:MEDCARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:B.
Authorized Official - Middle Name:
Authorized Official - Last Name:KABBANI
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:847-724-7600
Mailing Address - Street 1:1873 WAUKEGAN RD
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-2158
Mailing Address - Country:US
Mailing Address - Phone:847-724-7600
Mailing Address - Fax:
Practice Address - Street 1:153 1/2 BROADWAY AVE
Practice Address - Street 2:PHYSICAL THERAPY
Practice Address - City:MELROSE PARK
Practice Address - State:IL
Practice Address - Zip Code:60161
Practice Address - Country:US
Practice Address - Phone:708-628-7200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-14
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL70006734225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209349OtherMEDICARE