Provider Demographics
NPI:1528053287
Name:CRS REHABILITATION SPECIALISTS OF MUNSTER
Entity type:Organization
Organization Name:CRS REHABILITATION SPECIALISTS OF MUNSTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:K
Authorized Official - Last Name:DANIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-531-0099
Mailing Address - Street 1:9200 CALUMET AVE
Mailing Address - Street 2:SUITE N100
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-2885
Mailing Address - Country:US
Mailing Address - Phone:219-513-0500
Mailing Address - Fax:219-513-0600
Practice Address - Street 1:9200 CALUMET AVE
Practice Address - Street 2:SUITE N100
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2885
Practice Address - Country:US
Practice Address - Phone:219-513-0500
Practice Address - Fax:219-513-0600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN15-6598Medicare ID - Type Unspecified