Provider Demographics
NPI:1023623055
Name:PARADIGM REHAB AND CONSULTANCY INC
Entity type:Organization
Organization Name:PARADIGM REHAB AND CONSULTANCY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JOSE VICENTE
Authorized Official - Middle Name:
Authorized Official - Last Name:INOCENCIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:737-727-0798
Mailing Address - Street 1:2711 N MCVICKER AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60639-1115
Mailing Address - Country:US
Mailing Address - Phone:737-727-0798
Mailing Address - Fax:773-688-9682
Practice Address - Street 1:2711 N MCVICKER AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60639-1115
Practice Address - Country:US
Practice Address - Phone:737-727-0798
Practice Address - Fax:773-688-9682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty