Basic Information
| Provider Information | |||||||||
| NPI: | 1902241391 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | POST-ACUTE PHYSICIANS OF ILLINOIS LLC | ||||||||
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| OtherOrganizationName: | ANITA DURGA LLC | ||||||||
| OtherOrganizationType: | 4 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1776 WOODSTEAD CT | ||||||||
| Address2: | SUITE 208 | ||||||||
| City: | THE WOODLANDS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773801480 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8777497428 | ||||||||
| FaxNumber: | 2817243100 | ||||||||
| Practice Location | |||||||||
| Address1: | 815 E IRVING PARK RD | ||||||||
| Address2: | |||||||||
| City: | STREAMWOOD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601073073 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6308375300 | ||||||||
| FaxNumber: | 6302139076 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/30/2013 | ||||||||
| LastUpdateDate: | 04/09/2020 | ||||||||
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| AuthorizedOfficialLastName: | VARGAS | ||||||||
| AuthorizedOfficialFirstName: | JOSE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 8777497428 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 04/09/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 036.112327 | IL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.