Provider Demographics
NPI:1700130473
Name:REHAB CLIINIC OF AMERICA INC
Entity Type:Organization
Organization Name:REHAB CLIINIC OF AMERICA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OMRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ISMAIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-663-2111
Mailing Address - Street 1:5565 W 95TH STREET
Mailing Address - Street 2:SUITE 1F
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-3788
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5565 W 95TH STREET
Practice Address - Street 2:SUITE 1F
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-3788
Practice Address - Country:US
Practice Address - Phone:708-663-2111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-02
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty