Provider Demographics
NPI:1043592801
Name:BEGINNERS DEPOOT ECE CONSULTING
Entity Type:Organization
Organization Name:BEGINNERS DEPOOT ECE CONSULTING
Other - Org Name:TYWANDA JILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TYWANDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:JILES
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, DT
Authorized Official - Phone:773-710-6897
Mailing Address - Street 1:346 W 113TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60628-4137
Mailing Address - Country:US
Mailing Address - Phone:773-495-5152
Mailing Address - Fax:
Practice Address - Street 1:346 W 113TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60628-4137
Practice Address - Country:US
Practice Address - Phone:773-495-5152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILTJ35590103P252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency