Organization
COMMUNITY PROFESSIONAL REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHRAG TEBRY (PRESIDENT)
(773) 374-7800
Entity
Organization
Contact information
Practice address
10559 S TORRENCE AVE, CHICAGO, IL 60617-6154
(773) 374-7800
(773) 374-9091
Mailing address
10559 S TORRENCE AVE, CHICAGO, IL 60617-6154
(773) 374-7800
(773) 374-9091
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
322888333001
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
322888333001
—
IL
Enumeration date
08/30/2006
Last updated
08/22/2020
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