Organization
SOVEREIGN REHABILITATION OF ILLINOIS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD RAUSCH PT (SENIOR VICE PRESIDENT)
(773) 755-7566
Entity
Organization
Contact information
Practice address
390 E CONGRESS PKWY, CRYSTAL LAKE, IL 60014-6202
(773) 755-7566
Mailing address
2835 N SHEFFIELD AVE SUITE 401, CHICAGO, IL 60657-5081
(773) 755-7566
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
06/28/2010
Last updated
06/28/2010
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