Provider Demographics
NPI:1023247855
Name:SUMMIT REHABILITATION CENTER, PC
Entity type:Organization
Organization Name:SUMMIT REHABILITATION CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FLORIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MIRANZADEH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:630-928-1430
Mailing Address - Street 1:915 HARGER RD STE 102
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1400
Mailing Address - Country:US
Mailing Address - Phone:630-928-1430
Mailing Address - Fax:630-928-1424
Practice Address - Street 1:915 HARGER RD
Practice Address - Street 2:SUITE 101
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1497
Practice Address - Country:US
Practice Address - Phone:630-928-1430
Practice Address - Fax:630-928-1424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-14
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy