Organization
ACCELERATED REHABILITATION CENTER OF KENOSHA LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC C WARNER (CEO)
(815) 577-2840
Entity
Organization
Contact information
Practice address
1294 S ROUTE 12, FOX LAKE, IL 60020-1950
(847) 973-9440
(847) 973-9442
Mailing address
2998 MOMENTUM PL, CHICAGO, IL 60689-5330
(262) 657-0222
(262) 657-7190
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6726070001
DMERC
IL
Enumeration date
10/16/2014
Last updated
10/16/2014
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