Provider Demographics
NPI:1487834461
Name:KATIEBUG THERAPY, LTD.
Entity Type:Organization
Organization Name:KATIEBUG THERAPY, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINIC DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RUZICKA
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC/SLP
Authorized Official - Phone:630-904-0700
Mailing Address - Street 1:2156 DEEP WATER LN
Mailing Address - Street 2:UNIT 110
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-8504
Mailing Address - Country:US
Mailing Address - Phone:630-904-0700
Mailing Address - Fax:630-904-0705
Practice Address - Street 1:2156 DEEP WATER LN
Practice Address - Street 2:UNIT 110
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-8504
Practice Address - Country:US
Practice Address - Phone:630-904-0700
Practice Address - Fax:630-904-0705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-07
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X, 225XP0200X, 235Z00000X
IL146003441235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty