Provider Demographics
NPI:1457689002
Name:MEGAN CARRICK, LLC
Entity Type:Organization
Organization Name:MEGAN CARRICK, LLC
Other - Org Name:KIDS-IN-SYNC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARRICK-WEIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MOTR/L
Authorized Official - Phone:815-353-2129
Mailing Address - Street 1:420 FRONTAGE ROAD SUITE 200
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60093
Mailing Address - Country:US
Mailing Address - Phone:847-784-9115
Mailing Address - Fax:847-784-9330
Practice Address - Street 1:420 FRONTAGE ROAD SUITE 200
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:IL
Practice Address - Zip Code:60093
Practice Address - Country:US
Practice Address - Phone:847-784-9115
Practice Address - Fax:847-784-9330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-19
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056-007384225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty