# EMPOWERME REHABILITATION IL AGENCY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043799083
- **Authorized official:** JANAKA DIAS (PRESIDENT)
- **Authorized official phone:** (314) 485-7979

## Contact information

- **Practice address:** 2225 W MORTON AVE, JACKSONVILLE, IL 62650-2626
- **Practice address phone:** (217) 245-2996
- **Mailing address:** 120 S CENTRAL AVE STE 1050, SAINT LOUIS, MO 63105-1731
- **Mailing address phone:** (314) 485-7979

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |

## Other

- **Enumeration date:** 08/10/2018
- **Last updated:** 08/10/2018