Provider Demographics
NPI:1568648160
Name:EXCEL REHABILITATION SERVICES,INC
Entity Type:Organization
Organization Name:EXCEL REHABILITATION SERVICES,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHISYCAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:RENATA
Authorized Official - Middle Name:
Authorized Official - Last Name:FIRLEJ
Authorized Official - Suffix:
Authorized Official - Credentials:MRS
Authorized Official - Phone:847-279-8008
Mailing Address - Street 1:47 W DUNDEE RD
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:IL
Mailing Address - Zip Code:60090-4894
Mailing Address - Country:US
Mailing Address - Phone:847-279-8008
Mailing Address - Fax:847-279-8006
Practice Address - Street 1:47 W DUNDEE RD
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:IL
Practice Address - Zip Code:60090-4894
Practice Address - Country:US
Practice Address - Phone:847-279-8008
Practice Address - Fax:847-279-8006
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EXCEL REHABILITATION SERVICECES,INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-14
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04932419OtherBCBS
IL04932419OtherBCBS