Healthcare Provider Details

I. General information

NPI: 1770517963
Provider Name (Legal Business Name): ROBEELA DEANS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

456 25TH AVE
BELLWOOD IL
60104-1961
US

IV. Provider business mailing address

PO BOX 746715
ATLANTA GA
30374-6715
US

V. Phone/Fax

Practice location:
  • Phone: 708-467-7254
  • Fax:
Mailing address:
  • Phone: 708-467-7254
  • Fax: 815-642-5697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209-005775
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: