Provider Demographics
NPI:1205026580
Name:FOUNDATIONS FOR KIDS, INC
Entity Type:Organization
Organization Name:FOUNDATIONS FOR KIDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEVELOPMENTAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:PAULETTE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:OLLIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-587-4475
Mailing Address - Street 1:2355 FAIRCHILD LN
Mailing Address - Street 2:
Mailing Address - City:WEST CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60185-6167
Mailing Address - Country:US
Mailing Address - Phone:630-587-4475
Mailing Address - Fax:630-587-1907
Practice Address - Street 1:2355 FAIRCHILD LN
Practice Address - Street 2:
Practice Address - City:WEST CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60185-6167
Practice Address - Country:US
Practice Address - Phone:630-587-4475
Practice Address - Fax:630-587-1907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-01
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILPO75050199P222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Single Specialty