Organization
ILLINOIS REHAB PROVIDERS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. HAIDI SORIANO PHYSICAL THERAPIST (PRESIDENT)
(847) 414-0291
Entity
Organization
Contact information
Practice address
5139 DEMPSTER ST, SKOKIE, IL 60077-1802
(847) 414-0291
Mailing address
5139 DEMPSTER ST, SKOKIE, IL 60077-1802
(847) 414-0291
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
273348633
BCBS OF ILLINOIS
IL
05
—
273348633
—
IL
Enumeration date
09/16/2010
Last updated
09/16/2010
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