# SOVEREIGN REHAB

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

## Provider details

- **NPI number:** 1093114498
- **Authorized official:** MR. RICK RAUSCH PT (PRESIDENT)
- **Authorized official phone:** (630) 585-7337

## Contact information

- **Practice address:** 1315 MACOM DR. SUITE 103, NAPERVILLE, IL 60564
- **Practice address phone:** (630) 585-7337
- **Mailing address:** 1315 MACOM DR STE 103, NAPERVILLE, IL 60564-9360
- **Mailing address phone:** (630) 585-7337

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 070001782 | IL | Yes |

## Other

- **Enumeration date:** 08/21/2014
- **Last updated:** 08/21/2014