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Organization
ADVANCE CARE AND REHAB
Active
Organization
ADVANCE CARE AND REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABDUL MANNAN SHAMSUDDIN DPT (OWNER)
(224) 595-1631
Entity
Organization
Contact information
Practice address
2555 SUFFIELD ST, DES PLAINES, IL 60016-4831
(224) 595-1631
Mailing address
2555 SUFFIELD ST, DES PLAINES, IL 60016-4831
(224) 595-1631
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070023234
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619494838
—
IL
Enumeration date
04/11/2018
Last updated
04/11/2018
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