Organization
VITAL REHABILITATION ASSOC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD GREEN (DIRECTOR OF BUSINESS DEVELOPMENT)
(773) 685-8482
Entity
Organization
Contact information
Practice address
5820 W IRVING PARK RD, CHICAGO, IL 60634-2616
(773) 685-8482
(773) 685-8479
Mailing address
5820 W IRVING PARK RD, CHICAGO, IL 60634-2616
(773) 685-8482
(773) 685-8479
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
070009026
IL
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
03/12/2008
Last updated
10/19/2011
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