Provider Demographics
NPI:1407020233
Name:ALLCARE THERAPEUTIC SYSTEM
Entity type:Organization
Organization Name:ALLCARE THERAPEUTIC SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:GAMAL
Authorized Official - Middle Name:RIAD
Authorized Official - Last Name:IBRAHIM
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:708-566-0816
Mailing Address - Street 1:3400 W 111TH ST
Mailing Address - Street 2:#158
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60655-3330
Mailing Address - Country:US
Mailing Address - Phone:708-566-0816
Mailing Address - Fax:708-233-0341
Practice Address - Street 1:6322 S PULASKI RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60629-4706
Practice Address - Country:US
Practice Address - Phone:773-735-5800
Practice Address - Fax:773-735-5804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities