NPIMap

Organization Active NPI

Rehabilitation Medicine Clinic, Inc.

  • Rehabilitation Practitioner
  • Wheaton, IL
National Provider Identifier
1093818494
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Legal business name
REHABILITATION MEDICINE CLINIC, INC.
Practice address
26W171 Roosevelt Rd
Wheaton, IL 60187-6078
Phone
(630) 909-7350
Fax
(630) 909-7351
NPI assigned
Sep 7, 2006
Last updated
Aug 11, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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

Authorized official

Name
Mr. Michael Mullen
Title
Director
Phone
(630) 909-7354

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X Primary

Addresses

Primary practice location

26W171 Roosevelt Rd
Wheaton, IL 60187-6078

Mailing address

Dept 5777
Carol Stream, IL 60122-5777

Other identifiers 1

IdentifierTypeStateIssuer
0002230296OtherILBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

35679 Eagle Way
Chicago, IL 60678

17W682 Butterfield Rd
Ste 100
Oakbrook Terrace, IL 60181
Phone (630) 268-7800

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597104000000",
    "number": "1093818494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 5777",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601225777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26W171 ROOSEVELT RD",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601876078",
            "telephone_number": "630-909-7350",
            "fax_number": "630-909-7351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHABILITATION MEDICINE CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A",
        "authorized_official_last_name": "MULLEN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "630-909-7354",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0002230296",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; 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.