Provider Demographics
NPI:1710161591
Name:REHAB MEDICINE CLINIC
Entity Type:Organization
Organization Name:REHAB MEDICINE CLINIC
Other - Org Name:CRS REHABILITATION SPECIALISTS
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER PATIENT FINANCIAL SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-909-6562
Mailing Address - Street 1:26W171 ROOSEVELT RD
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-6078
Mailing Address - Country:US
Mailing Address - Phone:630-909-6562
Mailing Address - Fax:708-531-1909
Practice Address - Street 1:26W171 ROOSEVELT ROAD
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-6078
Practice Address - Country:US
Practice Address - Phone:630-909-6562
Practice Address - Fax:708-531-1909
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARIANJOY REHABILITATION HOSPITAL AND CLINICS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-28
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN156621Medicare Oscar/Certification