Provider Demographics
NPI:1609533363
Name:ILLINOIS REHAB CARE, LLC
Entity Type:Organization
Organization Name:ILLINOIS REHAB CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HORI
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGHA
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:224-234-4622
Mailing Address - Street 1:1972 LARKIN AVE. UNIT E
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-5832
Mailing Address - Country:US
Mailing Address - Phone:224-234-4622
Mailing Address - Fax:
Practice Address - Street 1:1972 LARKIN AVE. UNIT E
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-5832
Practice Address - Country:US
Practice Address - Phone:224-234-4622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-17
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier