Medical and Rehababilitation Center of Chicago LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

MEDICAL AND REHABABILITATION CENTER OF CHICAGO LLC

Practice address

5241 S Cicero Ave
Chicago, IL 60632-4967

Phone

(773) 284-8811

Fax

(773) 284-6431

NPI assigned

Mar 7, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Malcom D Herzog, DPM

Title

Manager

Phone

(708) 380-7028

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1394150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394150400000",
    "number": "1063838522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5241 S CICERO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606324967",
            "telephone_number": "773-284-8811",
            "fax_number": "773-284-6431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5241 S CICERO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606324967",
            "telephone_number": "773-284-8811",
            "fax_number": "773-284-6431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL AND REHABABILITATION CENTER OF CHICAGO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-07",
        "last_updated": "2014-03-07",
        "status": "A",
        "authorized_official_last_name": "HERZOG",
        "authorized_official_first_name": "MALCOM",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "708-380-7028",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOWL",
            "identifier": "616225000",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Medi-Ray Portable, Inc
• Jameela Media, MD
• Rashaud K Media
• Medical Advocate Healthcare Services Corp
• Medical and Allied Resources Distributor LLC
• Medical Arts Clinic LLC
• Medical Associates of Chatam, LTD
• Medical Cardiology LTD
• Medical Care of North Chicago, LTD
• Medical Care Services LLC

• Physical Therapy Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Physical Therapy Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.