Provider Demographics
NPI:1568818904
Name:LEARN THROUGH PLAY DEVELOPMENTAL THERAPY SERVICES P/C
Entity Type:Organization
Organization Name:LEARN THROUGH PLAY DEVELOPMENTAL THERAPY SERVICES P/C
Other - Org Name:WYLENA NELL THORNTON
Other - Org Type:Other Name
Authorized Official - Title/Position:DEVELOPMENTAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:WYLENA
Authorized Official - Middle Name:NELL
Authorized Official - Last Name:THORNTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-785-0483
Mailing Address - Street 1:14513 S BENSLEY AVE
Mailing Address - Street 2:
Mailing Address - City:BURNHAM
Mailing Address - State:IL
Mailing Address - Zip Code:60633-2205
Mailing Address - Country:US
Mailing Address - Phone:708-785-0483
Mailing Address - Fax:708-730-3328
Practice Address - Street 1:680 WENTWORTH AVE
Practice Address - Street 2:
Practice Address - City:CALUMET CITY
Practice Address - State:IL
Practice Address - Zip Code:60409-6718
Practice Address - Country:US
Practice Address - Phone:708-785-0483
Practice Address - Fax:708-730-3328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-04
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Single Specialty