Provider Demographics
NPI:1528415668
Name:OPTIMAL CHOICE THERAPY, LLC
Entity Type:Organization
Organization Name:OPTIMAL CHOICE THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MIRANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:OTD, OTR/L
Authorized Official - Phone:312-919-4008
Mailing Address - Street 1:18310 CHERRY CREEK DR
Mailing Address - Street 2:UNIT 2
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-2932
Mailing Address - Country:US
Mailing Address - Phone:888-851-4221
Mailing Address - Fax:888-851-4221
Practice Address - Street 1:18310 CHERRY CREEK DR
Practice Address - Street 2:UNIT 2
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-2932
Practice Address - Country:US
Practice Address - Phone:888-851-4221
Practice Address - Fax:888-851-4221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-18
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.009367302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization