Provider Demographics
NPI:1639592736
Name:SENIOR HEALTHCARE & REHAB LLC
Entity Type:Organization
Organization Name:SENIOR HEALTHCARE & REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAHZAD
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:708-925-6170
Mailing Address - Street 1:15347 S 70TH CT
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-5156
Mailing Address - Country:US
Mailing Address - Phone:708-925-6170
Mailing Address - Fax:708-221-6416
Practice Address - Street 1:15347 S 70TH CT
Practice Address - Street 2:SUITE 2
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-5156
Practice Address - Country:US
Practice Address - Phone:708-925-6170
Practice Address - Fax:708-221-6416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-24
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty