Provider Demographics
NPI:1952371932
Name:MIDWEST REHABILITATION, P.A.
Entity type:Organization
Organization Name:MIDWEST REHABILITATION, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:G
Authorized Official - Last Name:SANKOORIKAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:785-357-6300
Mailing Address - Street 1:PO BOX 4372
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-0372
Mailing Address - Country:US
Mailing Address - Phone:785-357-6300
Mailing Address - Fax:785-357-6324
Practice Address - Street 1:3740 SW SPRINGCREEK LN
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66610-1221
Practice Address - Country:US
Practice Address - Phone:785-357-6300
Practice Address - Fax:785-357-6324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-24
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS110923Medicare ID - Type Unspecified