Provider Demographics
NPI:1497054050
Name:LUMIERE CHILDREN'S THERAPY, LLC
Entity Type:Organization
Organization Name:LUMIERE CHILDREN'S THERAPY, LLC
Other - Org Name:LUMIERE CHILDREN'S THERAPY, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:VASILIKITSA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTONOPOULOS
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP/L
Authorized Official - Phone:773-206-7997
Mailing Address - Street 1:1500 N CLYBOURN AVE UNIT C105
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-2295
Mailing Address - Country:US
Mailing Address - Phone:773-206-7997
Mailing Address - Fax:888-972-7531
Practice Address - Street 1:1500 N CLYBOURN AVE UNIT C105
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-2295
Practice Address - Country:US
Practice Address - Phone:312-242-1665
Practice Address - Fax:888-972-7531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-22
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral PediatricsGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Multi-Specialty