Organization
JDWI
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL BIELENDA (EXECUTIVE DIRECTOR)
(815) 777-2211
Entity
Organization
Contact information
Practice address
706 WEST ST, GALENA, IL 61036
(815) 777-2211
(815) 777-3386
Mailing address
PO BOX 6087, 706 WEST ST, GALENA, IL 61036
(815) 777-2211
(815) 777-3386
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
05/01/2007
Last updated
08/22/2020
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