Provider Demographics
NPI:1235288119
Name:PREVENTION WORK, INC
Entity Type:Organization
Organization Name:PREVENTION WORK, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROAT
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:630-548-2520
Mailing Address - Street 1:23005 S KENT RD
Mailing Address - Street 2:
Mailing Address - City:CHANNAHON
Mailing Address - State:IL
Mailing Address - Zip Code:60410-3019
Mailing Address - Country:US
Mailing Address - Phone:815-467-3831
Mailing Address - Fax:815-467-3989
Practice Address - Street 1:1049 REDONDO DR
Practice Address - Street 2:
Practice Address - City:ROMEOVILLE
Practice Address - State:IL
Practice Address - Zip Code:60446-3705
Practice Address - Country:US
Practice Address - Phone:815-886-5982
Practice Address - Fax:815-886-5983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL057000054224Z00000X
IL070.003158225100000X
IL870002850225100000X
IL160000783225200000X
IN056000256225X00000X
IL0560000256225XE1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No225XE1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistErgonomicsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL22OtherOCCUPATIONAL THERAPY