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Organization
PHYSICAL THERAPY REHAB OF ILLINOIS INC
Active
Organization
PHYSICAL THERAPY REHAB OF ILLINOIS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOSSAM R MOHAMED LPT (OWNER)
(630) 639-1153
Entity
Organization
Contact information
Practice address
205 E BUTTERFIELD RD, STE. #154, ELMHURST, IL 60126-5103
(630) 639-1153
(630) 261-0716
Mailing address
1S132 SUMMIT AVE, STE. #108, OAKBROOK TERRACE, IL 60181-3955
(630) 261-0727
(630) 261-0716
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070-007491
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02232534
BCBS OF IL PROVIDER #
IL
Enumeration date
02/01/2007
Last updated
06/02/2009
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