Healthcare Provider Details

I. General information

NPI: 1558499715
Provider Name (Legal Business Name): DEBORAH ANN BIROS PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEBORAH ANN KABARA

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 01/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9645 S WESTERN AVE
CHICAGO IL
60643-1722
US

IV. Provider business mailing address

790 REMINGTON BLVD
BOLINGBROOK IL
60440-4909
US

V. Phone/Fax

Practice location:
  • Phone: 773-239-2734
  • Fax: 773-239-2784
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070002655
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: