Provider Demographics
NPI:1225499908
Name:ORANGE PEDIATRIC THERAPY INC.
Entity Type:Organization
Organization Name:ORANGE PEDIATRIC THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ BCBA
Authorized Official - Prefix:MRS
Authorized Official - First Name:BROOKE
Authorized Official - Middle Name:ELLYN
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:MSED, BCBA
Authorized Official - Phone:312-927-1982
Mailing Address - Street 1:4000 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1712
Mailing Address - Country:US
Mailing Address - Phone:312-927-1982
Mailing Address - Fax:
Practice Address - Street 1:4000 GROVE ST
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1712
Practice Address - Country:US
Practice Address - Phone:312-927-1982
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-09
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1-13-12819103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty