Basic Information
| Provider Information | |||||||||
| NPI: | 1871546473 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | REHABILITATION ASSOCIATES OF THE MIDWEST, S.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 909 E PALATINE RD | ||||||||
| Address2: | |||||||||
| City: | PALATINE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600745551 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8477761400 | ||||||||
| FaxNumber: | 8477761424 | ||||||||
| Practice Location | |||||||||
| Address1: | 909 E PALATINE RD | ||||||||
| Address2: | |||||||||
| City: | PALATINE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600745551 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8477761400 | ||||||||
| FaxNumber: | 8477761424 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2006 | ||||||||
| LastUpdateDate: | 03/01/2016 | ||||||||
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| AuthorizedOfficialLastName: | SWANSON | ||||||||
| AuthorizedOfficialFirstName: | GREGORY | ||||||||
| AuthorizedOfficialMiddleName: | W | ||||||||
| AuthorizedOfficialTitleorPosition: | CFO, BUSINESS MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 8477761400 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | CPA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | IL | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | Clinical | 208100000X | IL | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.