Provider Demographics
NPI:1609108539
Name:DEER REHABILITATION SERVICES INC
Entity Type:Organization
Organization Name:DEER REHABILITATION SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:DEER
Authorized Official - Suffix:
Authorized Official - Credentials:DOCTOR OF COUNSELING
Authorized Official - Phone:773-826-0398
Mailing Address - Street 1:3936 W ROOSEVELT RD
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60624-4389
Mailing Address - Country:US
Mailing Address - Phone:773-826-0398
Mailing Address - Fax:773-826-2327
Practice Address - Street 1:3936 W ROOSEVELT RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60624-4389
Practice Address - Country:US
Practice Address - Phone:773-826-0398
Practice Address - Fax:773-826-2327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-03
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILA51920001A101YA0400X
IL180003346101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty