Provider Demographics
NPI:1821258013
Name:ACHIEVE ORTHOPEDIC REHABILITATION SPECIALISTS,LLC
Entity Type:Organization
Organization Name:ACHIEVE ORTHOPEDIC REHABILITATION SPECIALISTS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:PT,MS,OCS
Authorized Official - Phone:708-403-1155
Mailing Address - Street 1:9121 159TH ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:ORLAND HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60487-5901
Mailing Address - Country:US
Mailing Address - Phone:708-403-1155
Mailing Address - Fax:708-403-1177
Practice Address - Street 1:9121 159TH ST
Practice Address - Street 2:SUITE D
Practice Address - City:ORLAND HILLS
Practice Address - State:IL
Practice Address - Zip Code:60487-5901
Practice Address - Country:US
Practice Address - Phone:708-403-1155
Practice Address - Fax:708-403-1177
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACHIEVE ORTHOPEDIC REHABILITATION SPECIALISTS,LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-11
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization