Provider Demographics
NPI:1215970082
Name:POREMBA LTD DBA REHAB CONNECTIONS PC
Entity type:Organization
Organization Name:POREMBA LTD DBA REHAB CONNECTIONS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR, CLINICAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:L
Authorized Official - Last Name:POREMBA
Authorized Official - Suffix:
Authorized Official - Credentials:PT CCM
Authorized Official - Phone:708-301-9933
Mailing Address - Street 1:14821 FOUNDERS XING
Mailing Address - Street 2:
Mailing Address - City:HOMER GLEN
Mailing Address - State:IL
Mailing Address - Zip Code:60491-6705
Mailing Address - Country:US
Mailing Address - Phone:708-301-9933
Mailing Address - Fax:708-301-4450
Practice Address - Street 1:14821 FOUNDERS XING
Practice Address - Street 2:
Practice Address - City:HOMER GLEN
Practice Address - State:IL
Practice Address - Zip Code:60491-6705
Practice Address - Country:US
Practice Address - Phone:708-301-9933
Practice Address - Fax:708-301-4450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL9926776OtherBLUE CROSS/BLUE SHIELD ID
IL201356Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID NUMB