Provider Demographics
NPI:1154914638
Name:POWERCARE REHABILITATION CORP
Entity type:Organization
Organization Name:POWERCARE REHABILITATION CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OF ENTITY
Authorized Official - Prefix:
Authorized Official - First Name:ELLAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DE GUZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-275-3611
Mailing Address - Street 1:15507 S ROUTE 59 STE 4
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-2723
Mailing Address - Country:US
Mailing Address - Phone:858-275-3611
Mailing Address - Fax:888-316-7811
Practice Address - Street 1:15507 S ROUTE 59 STE 4
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-2723
Practice Address - Country:US
Practice Address - Phone:858-275-3611
Practice Address - Fax:888-316-7811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-16
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty