=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770517963
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROBEELA DEANS NP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/11/2006
-----------------------------------------------------
Last Update Date | 09/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 456 25TH AVE
-----------------------------------------------------
City | BELLWOOD
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60104-1961
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 708-467-7254
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 746715
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30374-6715
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 708-467-7254
-----------------------------------------------------
Fax | 815-642-5697
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 209-005775
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------