MEDICARE: DEER REHABILITATION SERVICES INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	000014008	IL

General Provider Information

NPI Number	:	1588054704
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEER REHABILITATION SERVICES INC.

Provider Business Mailing Address
First Line	:	3936 W ROOSEVELT RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60624-4389
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3936 W ROOSEVELT RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60624-4389
Country	:	US
Telephone Number	:	773-826-0398
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DENNIS DEER
Credential	:
Telephone Number	:	773-826-0398

Provider Enumeration Date	:	01/26/2015
Last Update Date	:	01/26/2015

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