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Organization
PRAIRIE STATE REHAB, LLC
Active
Organization
PRAIRIE STATE REHAB, LLC
Active
Other names
Prairie State Rehab, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON FREEMAN DO (CEO)
(708) 275-4087
Entity
Organization
Contact information
Practice address
711 S DEARBORN ST UNIT 705, CHICAGO, IL 60605-3820
(708) 966-9283
(708) 258-1632
Mailing address
711 S DEARBORN ST UNIT 705, CHICAGO, IL 60605-3820
(708) 966-9283
(708) 258-1632
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
12/10/2020
Last updated
12/10/2020
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