Skip to Content

Request an Appointment

Pediatric Rehabilitation Services

Please provide the following information and we will contact you to schedule your appointment.

If you need to schedule a Rehabilitation Services visit for an adult, please click here.

Appointment Preferences

Preferred Day(s) and Time(s) Any
Mon.
Tues.
Wed.
Thurs.
Fri.
Sat.

Any
Morning Hours (Before 11 AM)
Mid-day (11 AM - 3 PM)
Afternoon (3 PM - 5 PM)
Evening (5 PM - 7 PM - when available)

Your Information

Name *

Street Address *

City *

State

Zip Code *

Contact Information *

Please contact me by Phone

Please contact me by Email

Date of Birth *

Are you an existing patient? *

Insurance Carrier *

Submit Request

Evanston Hospital | 847.570.2000
2650 Ridge Avenue, Evanston, IL 60201
Glenbrook Hospital | 847.657.5800
2100 Pfingsten Road, Glenview IL 60026
Highland Park Hospital | 847.432.8000
777 Park Avenue West, Highland Park, IL 60035
Skokie Hospital | 847.677.9600
9600 Gross Point Road, Skokie, IL 60076

Download the NorthShoreConnect app to access your health information on your mobile phone.

A Teaching Affiliate of