Provider Demographics
NPI:1609942937
Name:REHABILITATION INSTITUTE OF CHICAGO
Entity Type:Organization
Organization Name:REHABILITATION INSTITUTE OF CHICAGO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:PETERS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:708-427-3650
Mailing Address - Street 1:734 N ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-1728
Mailing Address - Country:US
Mailing Address - Phone:708-386-5019
Mailing Address - Fax:
Practice Address - Street 1:420 THATCHER AVE
Practice Address - Street 2:
Practice Address - City:RIVER FOREST
Practice Address - State:IL
Practice Address - Zip Code:60305-1635
Practice Address - Country:US
Practice Address - Phone:708-427-3650
Practice Address - Fax:708-427-3651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital