Provider Demographics
NPI:1093971970
Name:THERASYS CORPORATION
Entity Type:Organization
Organization Name:THERASYS CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:K
Authorized Official - Last Name:BAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-631-6227
Mailing Address - Street 1:5005 NEWPORT DR
Mailing Address - Street 2:SUITE 401
Mailing Address - City:ROLLING MEADOWS
Mailing Address - State:IL
Mailing Address - Zip Code:60008-3832
Mailing Address - Country:US
Mailing Address - Phone:847-797-1050
Mailing Address - Fax:847-797-1337
Practice Address - Street 1:183 N ADDISON AVE
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-2748
Practice Address - Country:US
Practice Address - Phone:630-279-0404
Practice Address - Fax:630-279-4690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL213437Medicare PIN