Southern Rehab Specialists, LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

056.007020 Issued in IL

Legal business name

SOUTHERN REHAB SPECIALISTS, LLC

Practice address

3216 Mustang CT
Herrin, IL 62948-3783

Phone

(618) 559-5610

NPI assigned

Jul 17, 2012

Organization subpart

No

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

Authorized official

Name

Sarah Renee Surprenant, OTR/L

Title

Owner, Occupational Therapist

Phone

(618) 559-5610

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sara Adrienne Wylie, M.S., SLP-CF

  • Speech-Language Pathologist
  • Marion, IL
  • NPI 1659515922
  NPD (past)

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342483200000",
    "number": "1699020552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3216 MUSTANG CT",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483783",
            "telephone_number": "618-559-5610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3216 MUSTANG CT",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483783",
            "telephone_number": "618-559-5610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN REHAB SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-17",
        "last_updated": "2012-07-17",
        "status": "A",
        "authorized_official_last_name": "SURPRENANT",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "OWNER, OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "618-559-5610",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.007020",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.009800",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southern Illinois OB-GYN Associates, S.C.
• Southern Illinois Orthopedic Center,LLC
• Southern Illinois Respiratory Disease Consultants, LLC
• Southern Illinois Rheumatology, SC
• Southern Orthopedic Associates SC
• Courtney Sowels, PHARMD
• Natalie Spiller, PA-C
• Sydney Spiller, MS, CCC-SLP
• Melinda Squires, LCSW
• Emilee Ann Stacey, RBT

• Occupational Therapist in Herrin, IL
• Providers in Herrin, IL by specialty
• Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.