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Organization

SOVEREIGN REHABILITATION OF ILLINOIS LLC

Active
Parent organization
SOVEREIGN REHABILITATION
Other names
Sovereign Rehabilitation
Organization subpart
Yes

Provider details

NPI number
Legal business name
SOVEREIGN REHABILITATION
Authorized official
RICHARD W RAUSCH PT (PRESIDENT)
(773) 755-7566
Entity
Organization

Contact information

Practice address
2835 N SHEFFIELD AVE, SUITE 401, CHICAGO, IL 60657-5081
(773) 755-7566
(773) 755-7580
Mailing address
2835 N SHEFFIELD AVE, SUITE 401, CHICAGO, IL 60657-5081
(773) 755-7566
(773) 755-7580

Taxonomy

Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
070001827
IL

Other

Enumeration date
04/14/2009
Last updated
05/29/2009
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