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Organization
REHABEDGE, LLC
Active
Organization
REHABEDGE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MEKALA PT (OWNER)
(217) 532-3330
Entity
Organization
Contact information
Practice address
127 N MAIN ST, HILLSBORO, IL 62049
(217) 532-3330
(217) 532-5149
Mailing address
127 N MAIN ST, HILLSBORO, IL 62049
(217) 532-3330
(217) 532-5149
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070008303
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
204049
MEDICARE PTAN
IL
05
—
631493557001
—
IL
Enumeration date
12/11/2006
Last updated
04/01/2013
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