MEDICARE: ACORN REHAB SERVICES LTD

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	103TP2701X	Group Psychotherapy Psychologist		IL

General Provider Information

NPI Number	:	1982808655
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACORN REHAB SERVICES LTD

Provider Business Mailing Address
First Line	:	1506 S SAWYER AVE
Second Line	:	UNIT #2
City	:	CHICAGO
State	:	IL
Zip	:	60623-2120
Country	:	US
Telephone Number	:	773-287-1822
Fax Number	:

Provider Business Practice Location Address
First Line	:	4639 W WASHINGTON BLVD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60644-3618
Country	:	US
Telephone Number	:	773-287-1822
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	FRANK PARKER
Credential	:	M.D.
Telephone Number	:	773-287-1822

Provider Enumeration Date	:	06/14/2007
Last Update Date	:	08/22/2020

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