Provider Demographics
NPI:1205229572
Name:LEAPS AND BOUNDS THERAPY LLC
Entity Type:Organization
Organization Name:LEAPS AND BOUNDS THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANERI
Authorized Official - Middle Name:DALIA
Authorized Official - Last Name:BHANSALI
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:312-480-7433
Mailing Address - Street 1:455 BUTLER DR
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60045-3013
Mailing Address - Country:US
Mailing Address - Phone:312-480-7433
Mailing Address - Fax:312-610-5655
Practice Address - Street 1:455 BUTLER DR
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:IL
Practice Address - Zip Code:60045-3013
Practice Address - Country:US
Practice Address - Phone:312-480-7433
Practice Address - Fax:312-610-5655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-11
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Single Specialty