Basic Information
| Provider Information | |||||||||
| NPI: | 1700995990 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | REHABTECH, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4060 N MAIN ST | ||||||||
| Address2: | SUITE 108 | ||||||||
| City: | RACINE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 534023121 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2626391353 | ||||||||
| FaxNumber: | 2626391425 | ||||||||
| Practice Location | |||||||||
| Address1: | 335 EISENHOWER LN S | ||||||||
| Address2: | |||||||||
| City: | LOMBARD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601485406 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6304244400 | ||||||||
| FaxNumber: | 6304240285 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2006 | ||||||||
| LastUpdateDate: | 05/12/2011 | ||||||||
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| AuthorizedOfficialLastName: | TOGLIATTI | ||||||||
| AuthorizedOfficialFirstName: | REBECCA | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 2626391353 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | REHABTECH, INC. | ||||||||
| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | IL | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
ID Information
| ID | Type | State | Issuer | Description | 203000171 | 05 | IL | MEDICAID |