Provider Demographics
NPI:1851866867
Name:SONIA SHANKMAN ORTHOGENIC SCHOOL
Entity Type:Organization
Organization Name:SONIA SHANKMAN ORTHOGENIC SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ABBY
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-420-2883
Mailing Address - Street 1:SONIA SHANKMAN ORTHOGENIC SCHOOL
Mailing Address - Street 2:6245 SOUTH INGLESIDE AVE
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60637-2621
Mailing Address - Country:US
Mailing Address - Phone:773-420-2883
Mailing Address - Fax:773-420-2804
Practice Address - Street 1:SONIA SHANKMAN ORTHOGENIC SCHOOL
Practice Address - Street 2:6245 SOUTH INGLESIDE AVE
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-2621
Practice Address - Country:US
Practice Address - Phone:773-420-2883
Practice Address - Fax:773-420-2804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-05
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children