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Organization

ADVANCE CARE AND REHAB

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ABDUL MANNAN SHAMSUDDIN DPT (OWNER)
(224) 595-1631
Entity
Organization

Contact information

Practice address
2555 SUFFIELD ST, DES PLAINES, IL 60016-4831
(224) 595-1631
Mailing address
2555 SUFFIELD ST, DES PLAINES, IL 60016-4831
(224) 595-1631

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070023234
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1619494838
IL
Enumeration date
04/11/2018
Last updated
04/11/2018
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