Provider Demographics
NPI:1497772909
Name:CHICAGOLAND THERAPY ASSOCIATES LTD
Entity Type:Organization
Organization Name:CHICAGOLAND THERAPY ASSOCIATES LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:GAINES
Authorized Official - Suffix:
Authorized Official - Credentials:GTR L
Authorized Official - Phone:847-835-0660
Mailing Address - Street 1:111 HOGARTH LN
Mailing Address - Street 2:PO BOX 417
Mailing Address - City:GLENCOE
Mailing Address - State:IL
Mailing Address - Zip Code:60022-1325
Mailing Address - Country:US
Mailing Address - Phone:847-835-0660
Mailing Address - Fax:847-835-0670
Practice Address - Street 1:111 HOGARTH LN
Practice Address - Street 2:BOX 417
Practice Address - City:GLENCOE
Practice Address - State:IL
Practice Address - Zip Code:60022-1325
Practice Address - Country:US
Practice Address - Phone:847-835-0660
Practice Address - Fax:847-835-0670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty