Provider Demographics
NPI:1639491764
Name:CADENCE SHAW INDUSTRIES
Entity Type:Organization
Organization Name:CADENCE SHAW INDUSTRIES
Other - Org Name:REACH FOR THE STARS PEDIATRIC THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAW
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:708-927-9800
Mailing Address - Street 1:6501 PINE POINT DR
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-2803
Mailing Address - Country:US
Mailing Address - Phone:708-927-9800
Mailing Address - Fax:708-231-0148
Practice Address - Street 1:6501 PINE POINT DR
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-2803
Practice Address - Country:US
Practice Address - Phone:708-927-9800
Practice Address - Fax:708-231-0148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-16
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056006309225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty