Basic Information
| Provider Information | |||||||||
| NPI: | 1841744463 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | REHABILITATION PROFESSIONALS, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1034 S BRENTWOOD BLVD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631171223 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3146441978 | ||||||||
| FaxNumber: | 3146445730 | ||||||||
| Practice Location | |||||||||
| Address1: | 700 WEBER RD | ||||||||
| Address2: | |||||||||
| City: | O FALLON | ||||||||
| State: | IL | ||||||||
| PostalCode: | 622692215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6186246000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/11/2016 | ||||||||
| LastUpdateDate: | 08/11/2016 | ||||||||
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| AuthorizedOfficialLastName: | FELSHER | ||||||||
| AuthorizedOfficialFirstName: | JONTY | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER/PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3146441978 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | PTA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
ID Information
| ID | Type | State | Issuer | Description | 146750 | 01 | IL | MEDICARE PTAN | OTHER |