Provider Demographics
NPI:1932218773
Name:COMMUNITY REHAB LLC
Entity Type:Organization
Organization Name:COMMUNITY REHAB LLC
Other - Org Name:ATI PHYSICAL THEARPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP CHIEF COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:WADE
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-296-2222
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:630-296-2222
Mailing Address - Fax:630-759-9510
Practice Address - Street 1:2601 CORNHUSKER DR STE 11
Practice Address - Street 2:
Practice Address - City:SOUTH SIOUX CITY
Practice Address - State:NE
Practice Address - Zip Code:68776-3919
Practice Address - Country:US
Practice Address - Phone:402-370-9651
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE83270OtherCOVENTRY GROUP
NE6400159Medicaid
NE01805OtherBLUE CROSS BLUE SHIELD
IA0586339Medicaid
NE193153203OtherDOL- OWCP
NES561OtherMIDLANDS CHOICE
NES561OtherMIDLANDS CHOICE
NECH3115Medicare ID - Type UnspecifiedRAILROAD MEDICARE
IA0586339Medicaid