Provider Demographics
NPI:1629787957
Name:AMA PEDIATRIC THERAPY NFP INC
Entity Type:Organization
Organization Name:AMA PEDIATRIC THERAPY NFP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:
Authorized Official - Last Name:FREIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-612-9092
Mailing Address - Street 1:363 E WACKER DR UNIT 3506
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-5815
Mailing Address - Country:US
Mailing Address - Phone:734-612-9092
Mailing Address - Fax:
Practice Address - Street 1:47 W POLK ST STE G15
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-2768
Practice Address - Country:US
Practice Address - Phone:312-724-2354
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-15
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral PediatricsGroup - Multi-Specialty
No252Y00000XAgenciesEarly Intervention Provider Agency
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental DisabilitiesGroup - Multi-Specialty