Provider Demographics
NPI:1720209141
Name:EARLY REHAB SERVICES INC
Entity Type:Organization
Organization Name:EARLY REHAB SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:SANTOSHKUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNDADA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-743-8801
Mailing Address - Street 1:801 S WILMETTE AVE
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-8624
Mailing Address - Country:US
Mailing Address - Phone:708-743-8801
Mailing Address - Fax:815-572-5174
Practice Address - Street 1:707 WESTWIND DR
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-9219
Practice Address - Country:US
Practice Address - Phone:708-743-8801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty