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NPI Code Detail

MEDICARE: DEER REHABILITATION SERVICES INC

MEDICARE: DEER REHABILITATION SERVICES INC
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorA51920001AIL
2101YP2500XProfessional Counselor180003346IL

General Provider Information

NPI Number : 1609108539
Entity Type Code : Organization
Provider Name (Legal Business Name) : DEER REHABILITATION SERVICES INC
Provider Business Mailing Address
First Line : 3936 W ROOSEVELT RD
Second Line :
City : CHICAGO
State : IL
Zip : 60624-4389
Country : US
Telephone Number : 773-826-0398
Fax Number : 773-826-2327
Provider Business Practice Location Address
First Line : 3936 W ROOSEVELT RD
Second Line :
City : CHICAGO
State : IL
Zip : 60624-4389
Country : US
Telephone Number : 773-826-0398
Fax Number : 773-826-2327
Authorized Official
Title or Position : PRESIDENT
Name : DR. DENNIS DEER
Credential : DOCTOR OF COUNSELING
Telephone Number : 773-826-0398
Provider Enumeration Date : 02/03/2010
Last Update Date : 05/20/2014

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1588054704 — DEER REHABILITATION SERVICES INC.
Practice Location Address:
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60624-4389
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Practice Fax:

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