Organization
ADVOCATE REHAB CLINIC, INC.
Active
Other names
Active Physical Therapy & Pain Management
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KHALED HUSSEIN DPT (PRESIDENT)
(708) 715-1122
Entity
Organization
Contact information
Practice address
5009 W 95TH ST, SUITE A, OAK LAWN, IL 60453-2401
(708) 499-2622
(708) 499-9466
Mailing address
5009 W 95TH ST, SUITE A, OAK LAWN, IL 60453-2401
(708) 715-1122
(708) 499-9466
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070006948
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001635584
BCBS PROV NO
—
05
—
338865784
—
IL
Enumeration date
09/25/2006
Last updated
03/09/2020
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