Provider Demographics
NPI:1033265467
Name:SEQUOIA THERAPY SERVICES, INC.
Entity Type:Organization
Organization Name:SEQUOIA THERAPY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SURESH
Authorized Official - Middle Name:REDDY
Authorized Official - Last Name:KARRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-532-5350
Mailing Address - Street 1:17838 HARPER RD
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-2139
Mailing Address - Country:US
Mailing Address - Phone:708-532-5350
Mailing Address - Fax:815-550-8703
Practice Address - Street 1:17838 HARPER RD
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-2139
Practice Address - Country:US
Practice Address - Phone:708-532-5350
Practice Address - Fax:815-550-8703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty