Organization
REHABILITATION MEDICINE CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL MULLEN (DIRECTOR)
(630) 909-7354
Entity
Organization
Contact information
Practice address
26W171 ROOSEVELT RD, WHEATON, IL 60187-6078
(630) 909-7350
(630) 909-7351
Mailing address
DEPT 5777, CAROL STREAM, IL 60122-5777
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002230296
BLUE CROSS BLUE SHIELD
IL
Enumeration date
09/07/2006
Last updated
08/11/2020
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