Basic Information
| Provider Information | |||||||||
| NPI: | 1538805528 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NEUROREHAB CONSULTANTS LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10660 W 143RD ST | ||||||||
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| City: | ORLAND PARK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604621982 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7084604499 | ||||||||
| FaxNumber: | 7084608031 | ||||||||
| Practice Location | |||||||||
| Address1: | 1200 NORTH ARLINGTON HEIGHTS ROAD | ||||||||
| Address2: | |||||||||
| City: | ARLINGTON HEIGHTS | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3128900637 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2022 | ||||||||
| LastUpdateDate: | 10/28/2022 | ||||||||
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| AuthorizedOfficialLastName: | RIPLEY | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3128900637 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 05/11/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Neurological Surgery |
No ID Information.