Organization
ALLIANCE REHAB STL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN CALLEN (PRESIDENT)
(630) 413-5820
Entity
Organization
Contact information
Practice address
723 S LACLEDE STATION RD, SAINT LOUIS, MO 63119-4911
(630) 413-5820
(630) 413-5845
Mailing address
28100 TORCH PKWY, SUITE 600, WARRENVILLE, IL 60555-3938
(630) 413-5930
(630) 413-5845
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
227800000X
Certified Respiratory Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LC0041807
STATE LICENSE NUMBER
MO
Enumeration date
05/18/2015
Last updated
05/18/2015
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