Provider Demographics
NPI:1790496644
Name:TINY STRIDES GIANT LEAPS, LLC
Entity Type:Organization
Organization Name:TINY STRIDES GIANT LEAPS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:WHEARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:312-722-9424
Mailing Address - Street 1:1865 HAWTHORNE AVE
Mailing Address - Street 2:
Mailing Address - City:WESTCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:60154-4358
Mailing Address - Country:US
Mailing Address - Phone:312-722-9424
Mailing Address - Fax:
Practice Address - Street 1:1865 HAWTHORNE AVE
Practice Address - Street 2:
Practice Address - City:WESTCHESTER
Practice Address - State:IL
Practice Address - Zip Code:60154-4358
Practice Address - Country:US
Practice Address - Phone:312-722-9424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty