MEDICARE: REHAB SERVICES ROOSEVELT, S.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	103T00000X	Psychologist
2	207Q00000X	Family Medicine Physician
3	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1598858839
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REHAB SERVICES ROOSEVELT, S.C.

Provider Business Mailing Address
First Line	:	3553 W PETERSON AVE
Second Line	:	SUITE 300
City	:	CHICAGO
State	:	IL
Zip	:	60659-3200
Country	:	US
Telephone Number	:	773-463-1313
Fax Number	:	773-463-5311

Provider Business Practice Location Address
First Line	:	5420 W ROOSEVELT RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60644-1420
Country	:	US
Telephone Number	:	773-379-9999
Fax Number	:	773-379-7113

Authorized Official
Title or Position	:	CEO
Name	:	MR. MARK BERGER
Credential	:
Telephone Number	:	773-519-0500

Provider Enumeration Date	:	09/30/2006
Last Update Date	:	09/11/2025

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