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General NPI Number Information
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NPI Number | 1205248622
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Entity Type | Organization
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Legal Business Name | DEER REHABILITATION SERVICES INC.
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Dates
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Enumeration Date | 05/21/2014
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Last Update Date | 05/21/2014
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Provider Practice Location Address
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Address Line | 1455 S MICHIGAN AVE STE 230
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City | CHICAGO
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State | IL
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Zip | 60605-2815
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Country | US
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Telephone | 773-826-0398
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Fax | 773-826-2327
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Provider Business Mailing Address
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Address Line | 3936 W ROOSEVELT RD
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City | CHICAGO
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State | IL
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Zip | 60624-4389
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Country | US
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Telephone | 773-826-0398
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Fax | 773-826-2327
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DENNIS DEER
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Credential | DOCTOR OF COUSELING
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Telephone | 773-826-0398
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 14008
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 14008
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License Number State | IL
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