Basic Information
| Provider Information | |||||||||
| NPI: | 1891045068 | ||||||||
| 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: | RICHMOND HEIGHTS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631171203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3146441978 | ||||||||
| FaxNumber: | 3146471350 | ||||||||
| Practice Location | |||||||||
| Address1: | 6840 N SACRAMENTO AVE | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606452740 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7734656700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/14/2012 | ||||||||
| LastUpdateDate: | 09/14/2012 | ||||||||
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| AuthorizedOfficialLastName: | GORDON | ||||||||
| AuthorizedOfficialFirstName: | JONATHAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3146441978 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | PT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 235Z00000X | N | 193200000X MULTI-SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | 225100000X | Y | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.