Provider Demographics
NPI:1598981631
Name:TRANSITIONS DEVELOPMENTAL THERAPY, P.C.
Entity Type:Organization
Organization Name:TRANSITIONS DEVELOPMENTAL THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BIANCA
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-296-5990
Mailing Address - Street 1:2225 ENTERPRISE DR
Mailing Address - Street 2:SUITE #2505
Mailing Address - City:WESTCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:60154-5814
Mailing Address - Country:US
Mailing Address - Phone:708-296-5990
Mailing Address - Fax:
Practice Address - Street 1:2225 ENTERPRISE DR
Practice Address - Street 2:SUITE #2505
Practice Address - City:WESTCHESTER
Practice Address - State:IL
Practice Address - Zip Code:60154-5814
Practice Address - Country:US
Practice Address - Phone:708-296-5990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services