Provider Demographics
NPI:1598802621
Name:ADVANCED REHABILITATION SERVICES PC
Entity Type:Organization
Organization Name:ADVANCED REHABILITATION SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANUSZ
Authorized Official - Middle Name:
Authorized Official - Last Name:PARZUCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-692-5991
Mailing Address - Street 1:5725 S ARCHER AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60638-1617
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5725 S ARCHER AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60638-1617
Practice Address - Country:US
Practice Address - Phone:708-692-5991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies