MEDICARE: ACHIEVE ORTHOPEDIC REHABILITATION SPECIALISTS,LLC

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
1	305R00000X	Preferred Provider Organization		IL

General Provider Information

NPI Number	:	1821258013
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACHIEVE ORTHOPEDIC REHABILITATION SPECIALISTS,LLC

Provider Business Mailing Address
First Line	:	9121 159TH ST
Second Line	:	SUITE D
City	:	ORLAND HILLS
State	:	IL
Zip	:	60487-5901
Country	:	US
Telephone Number	:	708-403-1155
Fax Number	:	708-403-1177

Provider Business Practice Location Address
First Line	:	9121 159TH ST
Second Line	:	SUITE D
City	:	ORLAND HILLS
State	:	IL
Zip	:	60487-5901
Country	:	US
Telephone Number	:	708-403-1155
Fax Number	:	708-403-1177

Authorized Official
Title or Position	:	OWNER
Name	:	ROBERT DEAN JOHNSON
Credential	:	PT,MS,OCS
Telephone Number	:	708-403-1155

Provider Enumeration Date	:	06/11/2008
Last Update Date	:	09/08/2011

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