Superior Rehab Center LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

SUPERIOR REHAB CENTER LLC

Practice address

4801 W Peterson Ave
615
Chicago, IL 60646-5713

Phone

(773) 283-4200

Fax

(773) 283-4209

NPI assigned

Jun 12, 2014

Organization subpart

No

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

Authorized official

Name

Roger Gomez

Title

Owner

Phone

(773) 767-3822

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1402531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402531200000",
    "number": "1982018461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "677 WILDROSE CIR",
            "city": "LAKE VILLA",
            "state": "IL",
            "postal_code": "600469021",
            "telephone_number": "773-767-3822",
            "fax_number": "773-337-9106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 W PETERSON AVE",
            "address_2": "615",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606465713",
            "telephone_number": "773-283-4200",
            "fax_number": "773-283-4209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERIOR REHAB CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-12",
        "last_updated": "2014-06-12",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-767-3822"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Chicago, IL
• Providers in Chicago, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2014; 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.