Provider Demographics
NPI:1447396270
Name:THERAPY PROVIDERS OF AMERICA INC.
Entity Type:Organization
Organization Name:THERAPY PROVIDERS OF AMERICA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MASHKOOR
Authorized Official - Middle Name:
Authorized Official - Last Name:ALIKHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-229-9828
Mailing Address - Street 1:3849 W 95TH STREET
Mailing Address - Street 2:THERAPY PROVIDERS BUSINESS OFFICE
Mailing Address - City:EVERGREEN PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60805
Mailing Address - Country:US
Mailing Address - Phone:708-229-9828
Mailing Address - Fax:708-422-0914
Practice Address - Street 1:4505 W 95TH ST
Practice Address - Street 2:THERAPY PROVIDERS
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2621
Practice Address - Country:US
Practice Address - Phone:708-229-0081
Practice Address - Fax:708-229-3964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1620958OtherBLUE CROSS BLUE SHIELD
IL132088700OtherOWCP DEPT OF LABOR
IL1620958OtherBLUE CROSS BLUE SHIELD