Rehabtech Supply, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

203001157 Issued in IL

Legal business name

REHABTECH SUPPLY, LLC

Practice address

655 W Grand Ave
Suite 100
Elmhurst, IL 60126-1060

Phone

(888) 800-9445

Fax

(888) 800-1991

NPI assigned

Jan 22, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Brian Dacy

Title

President

Phone

(888) 800-9445

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Life Tech Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Rehabtech Supply, LLC

  • Durable Medical Equipment & Medical Supplies
  • Maryland Heights, MO
  • NPI 1578232377

  7618189689

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Specialized Homecare Inc

  • Oxygen Equipment & Supplies (DME)
  • Lansing, MI
  • NPI 1467903005

  Member Of

  NPD member

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

{
    "created_epoch": "1264118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647561600000",
    "number": "1902137409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 W GRAND AVE",
            "address_2": "SUITE 100",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601261060",
            "telephone_number": "888-800-9445",
            "fax_number": "888-800-1991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W GRAND AVE",
            "address_2": "SUITE 100",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601261060",
            "telephone_number": "888-800-9445",
            "fax_number": "888-800-1991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHABTECH SUPPLY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-22",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A",
        "authorized_official_last_name": "DACY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "888-800-9445",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "203001157",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IN",
            "license": "69000699A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200994870 A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620078942",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1902137409",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Life Tech",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Life Tech",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Johanna Reedy
• Christina Rees
• Christopher Lee Reglen, MD
• Rehab Medical LLC
• Rehabit Concierge Physical Therapy
• Stephanie A Rehor, LCSW
• Gloria Reilly, PT, DPT
• Relive Physical Therapy of Elmhurst
• Lauren Remmes
• Victoria Residori, BCBA

• All providers in Elmhurst, IL
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.