NPIMap

Organization Active NPI

Genesis Rehab Services

  • Physical Disabilities Residential Treatment Facility
  • Chicago, IL
National Provider Identifier
1932453347
Registry record updated Nov 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X
License
160005776 Issued in IL
Legal business name
GENESIS REHAB SERVICES
Practice address
6700 S Keating Ave
Chicago, IL 60629-5660
Phone
(773) 767-6262
NPI assigned
Nov 7, 2012
Last updated
Nov 7, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
AUTUM GREEN VILLAGEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 7, 2012

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

Authorized official

Name
Fernando Rodrigue, PTA
Title
Physical Therapist Assistant
Phone
(708) 469-8497

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Disabilities Residential Treatment Facility 320700000X 160005776 IL Primary

Addresses

Primary practice location

6700 S Keating Ave
Chicago, IL 60629-5660

Mailing address

2239 Burr Oak Ave
North Riverside, IL 60546-1317
Phone (708) 469-8497

National Provider Directory

National Provider Directory
Tax ID family
Kimberly Hall South209 organizations share this tax ID, including this one
Part of
Kimberly Hall South

Organizations with this tax ID in the same state 7

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

NPI Registry JSON

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

{
    "created_epoch": "1352246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352246400000",
    "number": "1932453347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2239 BURR OAK AVE",
            "city": "NORTH RIVERSIDE",
            "state": "IL",
            "postal_code": "605461317",
            "telephone_number": "708-469-8497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6700 S KEATING AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606295660",
            "telephone_number": "773-767-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS REHAB SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AUTUM GREEN VILLAGE",
        "enumeration_date": "2012-11-07",
        "last_updated": "2012-11-07",
        "status": "A",
        "authorized_official_last_name": "RODRIGUE",
        "authorized_official_first_name": "FERNANDO",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST ASSISTANT",
        "authorized_official_telephone_number": "708-469-8497",
        "authorized_official_credential": "PTA"
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "IL",
            "license": "160005776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.