Healthcare Provider Details

I. General information

NPI: 1588929525
Provider Name (Legal Business Name): OPIOID ADDICTION RECOVERY SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2012
Last Update Date: 07/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 S MILWAUKEE AVE SUITE 210
LIBERTYVILLE IL
60048-3253
US

IV. Provider business mailing address

755 S MILWAUKEE AVE SUITE 210
LIBERTYVILLE IL
60048-3253
US

V. Phone/Fax

Practice location:
  • Phone: 847-247-0300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: ADAM RUBINSTEIN
Title or Position: OWNER
Credential: MD
Phone: 847-247-0300