Provider Demographics
NPI:1518623479
Name:ENCOMPASS HEALTH REHABILITATION HOSPITAL OF LIBERTYVILLE, LLC
Entity Type:Organization
Organization Name:ENCOMPASS HEALTH REHABILITATION HOSPITAL OF LIBERTYVILLE, LLC
Other - Org Name:ENCOMPASS HEALTH REHABILITATION INSTITUTE OF LIBERTYVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:WISNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-970-5702
Mailing Address - Street 1:1201 AMERICAN WAY
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-3935
Mailing Address - Country:US
Mailing Address - Phone:847-371-6500
Mailing Address - Fax:847-371-6895
Practice Address - Street 1:1201 AMERICAN WAY
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-3935
Practice Address - Country:US
Practice Address - Phone:847-371-6500
Practice Address - Fax:847-371-6895
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ENCOMPASS HEALTH CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-11-15
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital