Provider Demographics
NPI:1093756470
Name:NATURAL INSTINCTS
Entity Type:Organization
Organization Name:NATURAL INSTINCTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:MOROCCO-COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-469-1183
Mailing Address - Street 1:11617 S ADA ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-5126
Mailing Address - Country:US
Mailing Address - Phone:773-469-1183
Mailing Address - Fax:773-568-5629
Practice Address - Street 1:11113 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-3907
Practice Address - Country:US
Practice Address - Phone:773-469-1183
Practice Address - Fax:773-568-5629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2015-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070009896225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1636233OtherBCBS PPO