Express Medical Rehab, Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

EXPRESS MEDICAL REHAB, INC.

Practice address

4937 W Fullerton Ave
Chicago, IL 60639-2505

Phone

(177) 341-7301

NPI assigned

Sep 13, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Rae Escobar

Title

President

Phone

(773) 417-3012

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1347494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347494400000",
    "number": "1235489543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4937 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606392505",
            "telephone_number": "177-341-7301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4937 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606392505",
            "telephone_number": "177-341-7301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPRESS MEDICAL REHAB, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-13",
        "last_updated": "2012-09-13",
        "status": "A",
        "authorized_official_last_name": "ESCOBAR",
        "authorized_official_first_name": "RAE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "17734173012",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Chicago, IL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2012; 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.