MIDWEST REHABILITATION ASSOCIATES, S.C.

Provider Demographics

• NPI: 1598877375
• Name: MIDWEST REHABILITATION ASSOCIATES, S.C.
• Entity Type: Organization
• Organization Name: MIDWEST REHABILITATION ASSOCIATES, S.C.
• Authorized Official - Title/Position: EXECUTIVE DIRECTOR
• Authorized Official - Prefix: MRS
• Authorized Official - First Name: MARY
• Authorized Official - Last Name: WRIGHT
• Authorized Official - Phone: 414-476-8183
• Mailing Address - Street 1: 2525 N MAYFAIR RD
• Mailing Address - Street 2: SUITE 200
• Mailing Address - City: WAUWATOSA
• Mailing Address - State: WI
• Mailing Address - Zip Code: 53226-1403
• Mailing Address - Country: US
• Mailing Address - Phone: 414-476-8183
• Mailing Address - Fax: 414-476-8465
• Practice Address - Street 1: 2525 N MAYFAIR RD
• Practice Address - Street 2: SUITE 200
• Practice Address - City: WAUWATOSA
• Practice Address - State: WI
• Practice Address - Zip Code: 53226-1403
• Practice Address - Country: US
• Practice Address - Phone: 414-476-8183
• Practice Address - Fax: 414-476-8465
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2006-08-31
• Last Update Date: 2012-12-17

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	2081P2900X	Allopathic & Osteopathic Physicians	Physical Medicine & Rehabilitation	Pain Medicine	Group - Multi-Specialty
No	101YP2500X	Behavioral Health & Social Service Providers	Counselor	Professional	Group - Multi-Specialty
No	103T00000X	Behavioral Health & Social Service Providers	Psychologist		Group - Multi-Specialty
No	103TC0700X	Behavioral Health & Social Service Providers	Psychologist	Clinical	Group - Multi-Specialty
No	103TH0100X	Behavioral Health & Social Service Providers	Psychologist	Health Service	Group - Multi-Specialty
No	103TP2701X	Behavioral Health & Social Service Providers	Psychologist	Group Psychotherapy	Group - Multi-Specialty
No	1041C0700X	Behavioral Health & Social Service Providers	Social Worker	Clinical	Group - Multi-Specialty
No	208100000X	Allopathic & Osteopathic Physicians	Physical Medicine & Rehabilitation		Group - Multi-Specialty
No	2084N0400X	Allopathic & Osteopathic Physicians	Psychiatry & Neurology	Neurology	Group - Multi-Specialty
No	2084N0600X	Allopathic & Osteopathic Physicians	Psychiatry & Neurology	Clinical Neurophysiology	Group - Multi-Specialty
No	208VP0000X	Allopathic & Osteopathic Physicians	Pain Medicine	Pain Medicine	Group - Multi-Specialty
No	224Z00000X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Occupational Therapy Assistant		Group - Multi-Specialty
No	225100000X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Physical Therapist		Group - Multi-Specialty
No	225X00000X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Occupational Therapist		Group - Multi-Specialty
No	246ZE0600X	Technologists, Technicians & Other Technical Service Providers	Specialist/Technologist, Other	Electroneurodiagnostic	Group - Multi-Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
WI	21280000	Medicaid
WI	137184000	Other	US DEPT OF LABOR ID
WI	21280000	Medicaid
WI	137184000	Other	US DEPT OF LABOR ID