Basic Information
| Provider Information | |||||||||
| NPI: | 1053851618 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SKILLED REHABILITATION SPECIALISTS, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1513 NORFOLK AVE | ||||||||
| Address2: | |||||||||
| City: | WESTCHESTER | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601543737 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6304081117 | ||||||||
| FaxNumber: | 7085752876 | ||||||||
| Practice Location | |||||||||
| Address1: | 1513 NORFOLK AVE | ||||||||
| Address2: | |||||||||
| City: | WESTCHESTER | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601543737 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6304081117 | ||||||||
| FaxNumber: | 7085752876 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/02/2017 | ||||||||
| LastUpdateDate: | 03/02/2017 | ||||||||
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| AuthorizedOfficialLastName: | ALMOSHELLI | ||||||||
| AuthorizedOfficialFirstName: | BADER | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 6304081117 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | 208D00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | General Practice | 208100000X | 036134581 | IL | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.