Provider Demographics
NPI:1659605814
Name:ELMHURST REHABILITATION SERVICES, P.C.
Entity Type:Organization
Organization Name:ELMHURST REHABILITATION SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:LEONARD
Authorized Official - Last Name:HANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:630-236-6861
Mailing Address - Street 1:360 W BUTTERFIELD RD STE 150
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-5099
Mailing Address - Country:US
Mailing Address - Phone:630-834-0269
Mailing Address - Fax:
Practice Address - Street 1:360 W BUTTERFIELD RD STE 150
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-5099
Practice Address - Country:US
Practice Address - Phone:630-834-0269
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-21
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070011483273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit