Provider Demographics
NPI:1023101060
Name:GLOBAL REHABILITATION CLINIC, SC
Entity type:Organization
Organization Name:GLOBAL REHABILITATION CLINIC, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:SLAVIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-299-7000
Mailing Address - Street 1:8565 W DEMPSTER ST
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-1401
Mailing Address - Country:US
Mailing Address - Phone:847-299-7000
Mailing Address - Fax:847-299-7007
Practice Address - Street 1:8565 W DEMPSTER ST
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-1401
Practice Address - Country:US
Practice Address - Phone:847-299-7000
Practice Address - Fax:847-299-7007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL042617906261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL210033OtherMEDICARE PTAN
IL01632135OtherBCBS GROUP NUMBER
IL210033OtherMEDICARE PTAN