Provider Demographics
NPI:1083825111
Name:MULTIPLE MIRACLES THERAPEUTIC SERVICES L.L.C,
Entity Type:Organization
Organization Name:MULTIPLE MIRACLES THERAPEUTIC SERVICES L.L.C,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT -SPEECH PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DEER
Authorized Official - Suffix:
Authorized Official - Credentials:MA,, CCC-SLP-L
Authorized Official - Phone:773-619-2602
Mailing Address - Street 1:3510 W ARTHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60624-4105
Mailing Address - Country:US
Mailing Address - Phone:773-619-2602
Mailing Address - Fax:
Practice Address - Street 1:3333 W ARTHINGTON ST STE 230
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60624-4102
Practice Address - Country:US
Practice Address - Phone:773-826-3146
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty