Provider Demographics
NPI:1023140282
Name:NORTHWEST INDIANA REHABILITATION SERVICES, INC.
Entity type:Organization
Organization Name:NORTHWEST INDIANA REHABILITATION SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:MONICA
Authorized Official - Last Name:PLEITNER
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:219-836-1916
Mailing Address - Street 1:8517 FOREST AVENUE
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321
Mailing Address - Country:US
Mailing Address - Phone:219-836-1916
Mailing Address - Fax:219-836-4883
Practice Address - Street 1:8517 FOREST AVE
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2120
Practice Address - Country:US
Practice Address - Phone:219-836-1916
Practice Address - Fax:219-836-4883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31000122A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty