Healthcare Provider Details
I. General information
NPI: 1992649180
Provider Name (Legal Business Name): NEWRISE NEURO REHABILITATION CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/16/2026
Last Update Date: 04/19/2026
Certification Date: 04/19/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
171 N ABERDEEN ST STE 400
CHICAGO IL
60607-1670
US
IV. Provider business mailing address
171 N ABERDEEN ST STE 400
CHICAGO IL
60607-1670
US
V. Phone/Fax
- Phone: 773-875-9060
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TIFFANY
MARIE
STEVENS
Title or Position: CEO
Credential: LCPC
Phone: 773-875-9060