Provider Demographics
NPI:1679510721
Name:FLEXEON REHABILITATION OF FRANKFORT LLC
Entity type:Organization
Organization Name:FLEXEON REHABILITATION OF FRANKFORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:LAPORTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-427-4192
Mailing Address - Street 1:1420 KENSINGTON RD
Mailing Address - Street 2:STE 106
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-2143
Mailing Address - Country:US
Mailing Address - Phone:630-427-4192
Mailing Address - Fax:630-574-1681
Practice Address - Street 1:43 BANKVIEW DR
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-1861
Practice Address - Country:US
Practice Address - Phone:815-469-6676
Practice Address - Fax:815-469-1889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL210948Medicare PIN