Provider Demographics
NPI:1568599322
Name:BEYOND REHAB, LLC
Entity Type:Organization
Organization Name:BEYOND REHAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP- FINANCE & ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:ARNOLD
Authorized Official - Middle Name:AGBAY
Authorized Official - Last Name:AUGUSTO
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:847-219-2676
Mailing Address - Street 1:5101 WASHINGTON ST
Mailing Address - Street 2:SUITE 2G
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-5916
Mailing Address - Country:US
Mailing Address - Phone:847-249-9800
Mailing Address - Fax:847-249-9801
Practice Address - Street 1:1010 SANDERLING CT
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:IL
Practice Address - Zip Code:60002-6414
Practice Address - Country:US
Practice Address - Phone:847-395-7973
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1518Medicare PIN