Provider Demographics
NPI:1407195597
Name:OUT OF THE BOX THERAPIES, INC
Entity Type:Organization
Organization Name:OUT OF THE BOX THERAPIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DAMON
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:312-404-4578
Mailing Address - Street 1:1451 W WARNER AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-1912
Mailing Address - Country:US
Mailing Address - Phone:312-404-4578
Mailing Address - Fax:773-681-7227
Practice Address - Street 1:1451 W WARNER AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-1912
Practice Address - Country:US
Practice Address - Phone:312-404-4578
Practice Address - Fax:773-681-7227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-08
Last Update Date:2013-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty