Provider Demographics
NPI:1609135789
Name:TOWER HILL REHABILITATION, LLC
Entity Type:Organization
Organization Name:TOWER HILL REHABILITATION, LLC
Other - Org Name:TOWER HILL HEALTHCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:AMSTER
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:847-697-3310
Mailing Address - Street 1:759 KANE STREET
Mailing Address - Street 2:
Mailing Address - City:SOUTH ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60177-1418
Mailing Address - Country:US
Mailing Address - Phone:847-697-3310
Mailing Address - Fax:847-697-3354
Practice Address - Street 1:759 KANE ST
Practice Address - Street 2:
Practice Address - City:SOUTH ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60177-1418
Practice Address - Country:US
Practice Address - Phone:847-697-3310
Practice Address - Fax:847-697-3354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-10
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0051557332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid