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Organization
PRARIE STATE REHABILITATION, LLC
Active
Organization
PRARIE STATE REHABILITATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON DOUGLAS FREEMAN DO (OWNER)
(708) 275-4087
Entity
Organization
Contact information
Practice address
12220 S CHEYENNE DR, PALOS HEIGHTS, IL 60463-1654
(708) 275-4087
Mailing address
12220 S CHEYENNE DR, PALOS HEIGHTS, IL 60463-1654
(708) 275-4087
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
NULL
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Enumeration date
10/29/2018
Last updated
10/29/2018
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