Provider Demographics
NPI:1871546473
Name:REHABILITATION ASSOCIATES OF THE MIDWEST, S.C.
Entity type:Organization
Organization Name:REHABILITATION ASSOCIATES OF THE MIDWEST, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO, BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:W
Authorized Official - Last Name:SWANSON
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:847-776-1400
Mailing Address - Street 1:909 E PALATINE RD
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60074-5551
Mailing Address - Country:US
Mailing Address - Phone:847-776-1400
Mailing Address - Fax:847-776-1424
Practice Address - Street 1:909 E PALATINE RD
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60074-5551
Practice Address - Country:US
Practice Address - Phone:847-776-1400
Practice Address - Fax:847-776-1424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty