Provider Demographics
NPI:1265521959
Name:MILESTONE REHABILITATION
Entity type:Organization
Organization Name:MILESTONE REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHUBHRA
Authorized Official - Middle Name:ADITI
Authorized Official - Last Name:MEHRA
Authorized Official - Suffix:
Authorized Official - Credentials:BSC OTRL
Authorized Official - Phone:847-691-6516
Mailing Address - Street 1:474 PARKWOOD CIRCLE
Mailing Address - Street 2:
Mailing Address - City:SOUTH ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60177
Mailing Address - Country:US
Mailing Address - Phone:847-691-6516
Mailing Address - Fax:847-742-8419
Practice Address - Street 1:474 PARKWOOD CIRCLE
Practice Address - Street 2:
Practice Address - City:SOUTH ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60177
Practice Address - Country:US
Practice Address - Phone:847-691-6516
Practice Address - Fax:847-742-8419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)