Provider Demographics
NPI:1679308290
Name:ST JOSEPH REHABILITATION SERVICES LLC
Entity type:Organization
Organization Name:ST JOSEPH REHABILITATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PARAGAS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:815-715-1364
Mailing Address - Street 1:14228 MCCARTHY RD
Mailing Address - Street 2:
Mailing Address - City:LEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60439-9393
Mailing Address - Country:US
Mailing Address - Phone:815-715-1364
Mailing Address - Fax:630-243-0849
Practice Address - Street 1:14228 MCCARTHY RD
Practice Address - Street 2:
Practice Address - City:LEMONT
Practice Address - State:IL
Practice Address - Zip Code:60439-9393
Practice Address - Country:US
Practice Address - Phone:815-715-1364
Practice Address - Fax:630-243-0849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty