Provider Demographics
NPI:1881763035
Name:REHABILITATION SPECIALISTS OF CHICAGO, LLC
Entity type:Organization
Organization Name:REHABILITATION SPECIALISTS OF CHICAGO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:MARINKO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-323-2297
Mailing Address - Street 1:111 N LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3438
Mailing Address - Country:US
Mailing Address - Phone:630-323-2297
Mailing Address - Fax:630-323-2297
Practice Address - Street 1:1 INGALLS DR, NORTH 2 BLDG
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:IL
Practice Address - Zip Code:60426
Practice Address - Country:US
Practice Address - Phone:708-915-4588
Practice Address - Fax:708-915-5709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-095242208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL201846Medicare ID - Type Unspecified