Provider Demographics
NPI:1639498504
Name:THE THERAPLAY INSTITUTE
Entity Type:Organization
Organization Name:THE THERAPLAY INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ZAYA
Authorized Official - Middle Name:A
Authorized Official - Last Name:GILLOGLY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:224-850-3069
Mailing Address - Street 1:1224 W BELMONT AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-3207
Mailing Address - Country:US
Mailing Address - Phone:847-256-7334
Mailing Address - Fax:847-256-7337
Practice Address - Street 1:1224 W BELMONT AVE FL 1
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-3207
Practice Address - Country:US
Practice Address - Phone:847-256-7334
Practice Address - Fax:847-256-7337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-18
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1639498504OtherNPI#