Organization
SOVEREIGN REHABILITATION OF ILLINOIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOAN LAWRENCE (DIRECTOR)
(773) 755-7566
Entity
Organization
Contact information
Practice address
2335 W 95TH ST, CHICAGO, IL 60643-1003
(773) 755-7566
Mailing address
2835 N SHEFFIELD AVE, SUITE 401, CHICAGO, IL 60657-5081
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
070007656
IL
Other
Enumeration date
04/23/2010
Last updated
04/23/2010
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