Provider Demographics
NPI:1831479104
Name:REHAB DYNAMIX LTD
Entity Type:Organization
Organization Name:REHAB DYNAMIX LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:DR
Authorized Official - First Name:IAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:BELTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:773-358-8600
Mailing Address - Street 1:630 N. FRANKLIN ST
Mailing Address - Street 2:SUITE 801
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654
Mailing Address - Country:US
Mailing Address - Phone:773-358-8600
Mailing Address - Fax:773-304-2551
Practice Address - Street 1:5614 S PULASKI RD
Practice Address - Street 2:UPSTAIRS
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60629-4420
Practice Address - Country:US
Practice Address - Phone:773-358-8600
Practice Address - Fax:773-304-2551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-18
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038010386111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty