Provider Demographics
NPI:1912124306
Name:PROGRESSIVE HEALTH & REHABILITATION LTD
Entity type:Organization
Organization Name:PROGRESSIVE HEALTH & REHABILITATION LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:HUI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-632-9919
Mailing Address - Street 1:1283 W DUNDEE RD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-4009
Mailing Address - Country:US
Mailing Address - Phone:847-632-9919
Mailing Address - Fax:847-632-9981
Practice Address - Street 1:1283 W DUNDEE RD
Practice Address - Street 2:
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-4009
Practice Address - Country:US
Practice Address - Phone:847-632-9919
Practice Address - Fax:847-632-9981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-008505111NR0400X
IL07012126225100000X
IL038.008505247200000X
IL042-618646332B00000X
208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01635674OtherBCBS GROUP ID #
IL212932OtherMEDICARE PTAN
IL01635674OtherBCBS GROUP ID #
IL=========OtherTAX ID #