Provider Demographics
NPI:1477073815
Name:HUMMINGBIRD PEDIATRIC THERAPIES LLC
Entity Type:Organization
Organization Name:HUMMINGBIRD PEDIATRIC THERAPIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:JOSEPHINE
Authorized Official - Last Name:SCALISE MORRISSEY
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:630-853-3374
Mailing Address - Street 1:11 W BIRCHWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-2804
Mailing Address - Country:US
Mailing Address - Phone:630-853-3374
Mailing Address - Fax:630-789-8852
Practice Address - Street 1:750 PASQUINELLI DR STE 204
Practice Address - Street 2:
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-1291
Practice Address - Country:US
Practice Address - Phone:630-853-3374
Practice Address - Fax:630-789-8852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-27
Last Update Date:2017-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180006197101YP2500X
IL164001003133VN1004X
IL0700058902251P0200X
IL056004913225XP0200X
IL056005059225XP0200X
IL146005080235Z00000X
IL146011452235Z00000X
IL146011796235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, PediatricGroup - Multi-Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty