Provider Demographics
NPI:1740777879
Name:GROWING TOGETHER PEDIATRIC THERAPY, LLC
Entity Type:Organization
Organization Name:GROWING TOGETHER PEDIATRIC THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KOVACS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-217-3590
Mailing Address - Street 1:3143 LANDORE DR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-4100
Mailing Address - Country:US
Mailing Address - Phone:630-217-3590
Mailing Address - Fax:
Practice Address - Street 1:2211 N ELSTON AVE STE 102
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-2921
Practice Address - Country:US
Practice Address - Phone:312-358-1674
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-14
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty