Provider Demographics
NPI:1245705177
Name:REHABILITATION SPECIALISTS OF ILLINOIS LLC
Entity type:Organization
Organization Name:REHABILITATION SPECIALISTS OF ILLINOIS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARLES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-322-9900
Mailing Address - Street 1:PO BOX 53
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-0053
Mailing Address - Country:US
Mailing Address - Phone:815-322-9900
Mailing Address - Fax:815-630-3126
Practice Address - Street 1:301 SPRINGFIELD AVE
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-6590
Practice Address - Country:US
Practice Address - Phone:815-630-5119
Practice Address - Fax:815-630-3126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-08
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty