Organization
ADVANCED THERAPY& REHAB
Active
Parent organization
BOULEVARD HEALTHCARE, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
BOULEVARD HEALTHCARE, LLC
Authorized official
MRS. JENIFER CARLOS DE LARA PT, CWS, GCS (REGIONAL DIRECTOR OF THERAPY)
(847) 720-8851
Entity
Organization
Contact information
Practice address
6400 SHAFER CT, SUITE 600, ROSEMONT, IL 60018-4914
(847) 720-8700
Mailing address
6400 SHAFER CT, SUITE 600, ROSEMONT, IL 60018-4914
(847) 720-8700
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
01/11/2008
Last updated
01/11/2008
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