Organization
INDEPENDENCE HEALTH & THERAPY
Active
Parent organization
INDEPENDENCE HEALTH & THERAPY
Other names
Adult & Child Rehabilitation Center for McHenry County Illinois
Organization subpart
Yes
Provider details
NPI number
Legal business name
INDEPENDENCE HEALTH & THERAPY
Authorized official
MRS. KIMBERLY LARSON R.N. (EXECUTIVE DIRECTOR)
(815) 333-8657
Entity
Organization
Contact information
Practice address
708 WASHINGTON ST., WOODSTOCK, IL 60098
(815) 338-1707
(815) 338-1786
Mailing address
2028 N. SEMINARY AVE., WOODSTOCK, IL 60098
(815) 338-3590
(815) 337-4406
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
251K00000X
Public Health or Welfare Agency
1747736
IL
251K00000X
Public Health or Welfare Agency
Primary
—
—
261QR0400X
Rehabilitation Clinic/Center
1747736
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05615103
BLUE CROSS BLUE SHIELD
IL
05
—
362264411001
—
IL
Enumeration date
03/29/2007
Last updated
11/19/2018
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