# COVENANT ALLIANCE REHAB

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

## Provider details

- **NPI number:** 1720401193
- **Authorized official:** MR. JOHN CALLEN (PRESIDENT)
- **Authorized official phone:** (630) 413-5820

## Contact information

- **Practice address:** 1520 KENSINGTON RD, SUITE 110, OAK BROOK, IL 60523-2139
- **Practice address phone:** (630) 413-5800
- **Practice address fax:** (630) 413-5801
- **Mailing address:** 1520 KENSINGTON RD, SUITE 110, OAK BROOK, IL 60523-2139
- **Mailing address phone:** (630) 413-5800
- **Mailing address fax:** (630) 413-5801

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 2279G0305X | Geriatric Care Registered Respiratory Therapist | — | NULL | — |
| 2279G0305X | Geriatric Care Registered Respiratory Therapist | — | — | — |
| 231H00000X | Audiologist | — | NULL | — |
| 231H00000X | Audiologist | — | — | — |

## Other

- **Enumeration date:** 01/21/2014
- **Last updated:** 01/21/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 10414859 | STATE LICENSE NUMBER | AZ |