Provider Demographics
NPI:1790848588
Name:REHABILITATION INSTITUTE OF CHICAGO
Entity type:Organization
Organization Name:REHABILITATION INSTITUTE OF CHICAGO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPY
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLACAMPA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:312-238-6974
Mailing Address - Street 1:6700 S SOUTH SHORE DR
Mailing Address - Street 2:APT. 21E
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60649-1310
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5548 S HYDE PARK BLVD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-1909
Practice Address - Country:US
Practice Address - Phone:312-238-6974
Practice Address - Fax:773-256-5050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty