Provider Demographics
NPI:1043475882
Name:TODDLER THERAPY SERVICES INC
Entity Type:Organization
Organization Name:TODDLER THERAPY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SERVICE
Authorized Official - Prefix:
Authorized Official - First Name:KARIN
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-769-5316
Mailing Address - Street 1:5915 MUSKIE TRL
Mailing Address - Street 2:
Mailing Address - City:MORRIS
Mailing Address - State:IL
Mailing Address - Zip Code:60450-9649
Mailing Address - Country:US
Mailing Address - Phone:815-483-3303
Mailing Address - Fax:815-416-1267
Practice Address - Street 1:5915 MUSKIE TRL
Practice Address - Street 2:
Practice Address - City:MORRIS
Practice Address - State:IL
Practice Address - Zip Code:60450-9649
Practice Address - Country:US
Practice Address - Phone:815-483-3303
Practice Address - Fax:815-416-1267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056006304225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL321844939Medicaid