Provider Demographics
NPI:1487201752
Name:LEAPS AND BOUNDS PEDIATRIC THERAPY LLC
Entity Type:Organization
Organization Name:LEAPS AND BOUNDS PEDIATRIC THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:LINNETTE
Authorized Official - Last Name:GOLDIE
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:773-930-5958
Mailing Address - Street 1:227 SPRINGSIDE DR
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60124-8476
Mailing Address - Country:US
Mailing Address - Phone:773-930-5958
Mailing Address - Fax:888-958-4665
Practice Address - Street 1:227 SPRINGSIDE DR
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60124-8476
Practice Address - Country:US
Practice Address - Phone:773-930-5958
Practice Address - Fax:888-958-4665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-21
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty