Provider Demographics
NPI:1528398690
Name:ELITE REHAB SERVICES
Entity Type:Organization
Organization Name:ELITE REHAB SERVICES
Other - Org Name:ERS REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:INEZ
Authorized Official - Last Name:WEBSTER-WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:312-415-4600
Mailing Address - Street 1:215 E 31ST ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-4669
Mailing Address - Country:US
Mailing Address - Phone:312-415-4600
Mailing Address - Fax:
Practice Address - Street 1:215 E 31ST ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-4669
Practice Address - Country:US
Practice Address - Phone:312-415-4600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-12
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies