PRARIE STATE REHABILITATION, LLC (NPI# 1770050668) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770050668 |
| Entity Type | Organization |
| Organization Name | PRARIE STATE REHABILITATION, LLC |
| Practice Address |
12220 S Cheyenne Dr Palos Heights IL 60463-1654 |
| Practice Telephone | 7082754087 |
| Mailing Telephone | 7082754087 |
| Enumeration Date | 2018-10-29 |
| Last Update Date | 2018-10-29 |
| Authorized Official Name | JASON DOUGLAS FREEMAN (OWNER) |
| Authorized Official Telephone | 7082754087 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
12220 S CHEYENNE DR |
| City | PALOS HEIGHTS |
| State | IL |
| Zip Code | 60463-1654 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932756095 | Kim Rusiecki | Technician | 25 Parliament Drive East, Palos Heights, IL 60463 | 2019-08-23 |
| 1265925218 | Sentinel Anesthesia of Illinois, PC | Anesthesiology | 7340 W College Dr Fl 1, Palos Heights, IL 60463 | 2018-06-13 |
| 1225410848 | Deborah Ann Castaneda | Skilled Nursing Facility | 12350 Natchez Ave., Palos Heights, IL 60463 | 2015-06-19 |
| 1609253160 | Tareq Ayyad | Physical Therapy Assistant | 11730 Lighthouse Ln, Palos Heights, IL 60463 | 2015-05-04 |
| 1366846503 | Ryan Teahen | Dentist | 7600 W College Dr Ste 17, Palos Heights, IL 60463 | 2014-10-17 |
| 1295140309 | Paul Park | Ophthalmology | 7600 W College Dr Ste 9, Palos Heights, IL 60463 | 2014-06-26 |
| 1275976045 | Nazim A. Khan | Physician Assistant | 6450 West College Drive, Palos Heights, IL 60463 | 2013-04-11 |
| 1619246824 | Amanda M Ejka | Psychologist | 11800 South 75th Avenue, Suite 300, Palos Heights, IL 60463 | 2011-12-16 |
| 1578832937 | Sandi Maheras | Pharmacist | 1703 Spyglass Cir, Palos Heights, IL 60463 | 2011-12-14 |
| 1043597065 | Ashraf Olwan | Pharmacist | 7660 W Sequoia Rd, Palos Heights, IL 60463 | 2011-11-04 |
| Find all providers in zip 60463 | ||||
| Taxonomy Code | 2081P2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Pain Medicine |
| A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285256982 | Prm of Illinois | Physical Medicine & Rehabilitation | 625 N Michigan Ave Ste 810, Chicago, IL 60611-3110 | 2020-05-15 |
| 1346807724 | Complete Pain Management LLC | Physical Medicine & Rehabilitation | 16310 S Lincoln Hwy Ste 132, Plainfield, IL 60586-9100 | 2019-05-21 |
| 1376007757 | Jose Angel Munoz Jr. | Physical Medicine & Rehabilitation | 5035 W Parker Ave, Chicago, IL 60639-1603 | 2019-01-30 |
| 1053806406 | Naperville Rehab and Medical Clinic PC | Physical Medicine & Rehabilitation | 445 Jackson Ave Ste 102, Naperville, IL 60540-5257 | 2018-06-28 |
| 1457711418 | Elite Pain Medical Group Inc | Physical Medicine & Rehabilitation | 720 South Brom Drive, Suite 201, Naperville, IL 60540 | 2016-03-03 |
| 1992123004 | Bhavana Vaidya Md LLC | Physical Medicine & Rehabilitation | 10601 S Kilbourn Ave, Oak Lawn, IL 60453-5341 | 2014-04-04 |
| 1275966418 | Restorative Health Center Sc | Physical Medicine & Rehabilitation | 430 Barron Blvd, Grayslake, IL 60030-1666 | 2013-08-12 |
| 1629315312 | Chinatown Integrated Medicine Ltd | Physical Medicine & Rehabilitation | 2134b S Archer Ave Fl 2, Chicago, IL 60616-1514 | 2013-01-15 |
| 1760735377 | Suburban Medical & Rehab Clinic, Ltd | Physical Medicine & Rehabilitation | 269 S Roselle Rd, Schaumburg, IL 60193-1636 | 2012-10-19 |
| 1497048508 | Friedman Spine and Pain Clinic Ltd | Physical Medicine & Rehabilitation | 5205 Cypress Ct, Lisle, IL 60532-2007 | 2011-05-23 |
| Find all providers with the same taxonomy | ||||
| City | PALOS HEIGHTS |
| Zip Code | 60463 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.