Provider Demographics
NPI:1255691093
Name:ELITE REHAB PLAINFIELD LLC
Entity type:Organization
Organization Name:ELITE REHAB PLAINFIELD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:M
Authorized Official - Last Name:PIRIE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:815-267-6177
Mailing Address - Street 1:15412 S ROUTE 59
Mailing Address - Street 2:SUITE 118
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-2175
Mailing Address - Country:US
Mailing Address - Phone:815-267-6177
Mailing Address - Fax:815-782-7038
Practice Address - Street 1:15412 S ROUTE 59
Practice Address - Street 2:SUITE 118
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-2175
Practice Address - Country:US
Practice Address - Phone:815-267-6177
Practice Address - Fax:815-782-7038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-28
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty