Provider Demographics
NPI:1326132812
Name:TLC THERAPY, LTD.
Entity Type:Organization
Organization Name:TLC THERAPY, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:CIENKUS
Authorized Official - Suffix:
Authorized Official - Credentials:CCC/SLP
Authorized Official - Phone:815-546-1838
Mailing Address - Street 1:12843 BRADFORD LANE
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60585-2245
Mailing Address - Country:US
Mailing Address - Phone:815-546-1838
Mailing Address - Fax:815-609-3739
Practice Address - Street 1:12843 BRADFORD LANE
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60585-2245
Practice Address - Country:US
Practice Address - Phone:815-546-1838
Practice Address - Fax:815-609-3739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL9932132OtherBLUE CROSS/BLUE SHIELD ID