Organization
ALPHA REHAB CENTER, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ASHISH SUD DC (PRESIDENT)
(708) 317-5553
Entity
Organization
Contact information
Practice address
3253 HARLEM AVE, SUITE 3, BERWYN, IL 60402-2996
(708) 317-5553
(708) 788-4757
Mailing address
3253 HARLEM AVE, SUITE 3, BERWYN, IL 60402-2996
(708) 317-5553
(708) 788-4757
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
038010321
IL
111NR0400X
Rehabilitation Chiropractor
Primary
038010456
IL
225100000X
Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IL7746
MEDICARE PTAN
IL
Enumeration date
08/29/2012
Last updated
05/25/2021
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