Provider Demographics
NPI:1437807948
Name:MARBLES MATTER THERAPY GROUP, PLLC
Entity Type:Organization
Organization Name:MARBLES MATTER THERAPY GROUP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:RYNDAK
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:773-633-6211
Mailing Address - Street 1:14501 CENTRAL CT APT G4
Mailing Address - Street 2:
Mailing Address - City:OAK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60452-1033
Mailing Address - Country:US
Mailing Address - Phone:773-633-6211
Mailing Address - Fax:
Practice Address - Street 1:14501 CENTRAL CT APT G4
Practice Address - Street 2:
Practice Address - City:OAK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60452-1033
Practice Address - Country:US
Practice Address - Phone:773-633-6211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty