Provider Demographics
NPI:1710169537
Name:CORNERSTONE REHABILITATION INSTITUTE
Entity Type:Organization
Organization Name:CORNERSTONE REHABILITATION INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SEONG
Authorized Official - Middle Name:WOOK
Authorized Official - Last Name:CHOI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-390-8600
Mailing Address - Street 1:241 GOLF MILL CTR
Mailing Address - Street 2:SUITE 516
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-1224
Mailing Address - Country:US
Mailing Address - Phone:847-390-8600
Mailing Address - Fax:847-390-8609
Practice Address - Street 1:241 GOLF MILL CTR
Practice Address - Street 2:SUITE 516
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-1224
Practice Address - Country:US
Practice Address - Phone:847-390-8600
Practice Address - Fax:847-390-8609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-008845111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL211279OtherMEDICARE GROUP NUMBER
IL211279OtherMEDICARE GROUP NUMBER