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PEDIATRIC ADULT REHABILITATION ASSOCIATES NPI 1710965918


NPI Information

NPI: 1710965918
Provider Name: PEDIATRIC ADULT REHABILITATION ASSOCIATES

Doing Business As: PARA'S PEACH TREE

Classification: Specialist - 174400000X
Entity Type: Organization
Address:
350 HOUBOLT RD
SUITE 101
JOLIET, IL
ZIP 60431
Phone: (815) 725-9992
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PEDIATRIC ADULT REHABILITATION ASSOCIATES is a specialist in Joliet, IL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. PEDIATRIC ADULT REHABILITATION ASSOCIATES NPI is 1710965918. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Para's Peach Tree.

The provider's business location address is:

350 HOUBOLT RD
SUITE 101
JOLIET, IL
ZIP 60431-305
Phone: (815) 725-9992
Fax: (815) 725-9993

The provider's authorized official is Shauna J Ruzich .
The authorized official title is President/clinical Manager and has the following contact phone number (815) 725-9992.

The enumeration date for this NPI number is 1/6/2006 and was last updated on 8/22/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialistYes
2225100000XPhysical TherapistX
3225700000XMassage TherapistX
4235Z00000XSpeech-Language Pathologist22003708AINDIANAX
5225X00000XOccupational TherapistILLINOISX
62355S0801XSpecialist/TechnologistSpeech-Language AssistantILLINOISX
7235Z00000XSpeech-Language PathologistILLINOISX

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1405254137001MEDICAIDILLINOIS

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: 11/14/2023

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