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PRESENCE AMBULATORY SERVICE NPI 1336580026


NPI Information

NPI: 1336580026
Provider Name: PRESENCE AMBULATORY SERVICE

Doing Business As: PRESENCE REHAB CLINIC

Classification: Clinic/Center - 261QR0400X
Entity Type: Organization

Specialization: Rehabilitation

CLIA Number: 14D0996578

Address:
1625 SHERIDAN RD
SUITE 1A
WILMETTE, IL
ZIP 60091
Phone: (847) 256-2890
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PRESENCE AMBULATORY SERVICE is a rehabilitation clinic center in Wilmette, IL. PRESENCE AMBULATORY SERVICE NPI is 1336580026. The provider is registered as an organization entity type.
The provider Is Doing Business As Presence Rehab Clinic.

The provider's business location address is:

1625 SHERIDAN RD
SUITE 1A
WILMETTE, IL
ZIP 60091-824
Phone: (847) 256-2890
Fax: (847) 256-2802

The provider's authorized official is Melvonne Jones .
The authorized official title is Mgr, Credentialing and has the following contact phone number (630) 914-2417.

The CLIA number assigned to this NPI record is 14D0996578 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/10/2013 and was last updated on 7/10/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QR0400XClinic/CenterRehabilitationYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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