# ALEGENT HEALTH IMMANUEL MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Alegent Health IMC Rehab Prov Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497891543
- **Authorized official:** EVERT KUIPER (CEO - CHI HEALTH)
- **Authorized official phone:** (402) 343-4420

## Contact information

- **Practice address:** 6901 N 72ND ST, OMAHA, NE 68122-1709
- **Practice address phone:** (402) 572-2297
- **Mailing address:** PO BOX 642117, OMAHA, NE 68164-8117
- **Mailing address phone:** (402) 717-4377

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103G00000X | Clinical Neuropsychologist | — | NULL | — |
| 103G00000X | Clinical Neuropsychologist | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/29/2007
- **Last updated:** 02/10/2022