Organization
GENESIS REHAB SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KOURTNEY HICKS (PHYSICAL THERAPIST ASSISTANT)
(708) 374-9574
Entity
Organization
Contact information
Practice address
2649 E 75TH ST, CHICAGO, IL 60649-3835
(773) 721-5845
Mailing address
2649 E 75TH ST, CHICAGO, IL 60649-3835
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
160006340
IL
Other
Enumeration date
03/20/2013
Last updated
03/20/2013
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