Provider Demographics
NPI:1891016507
Name:SPECIAL THERAPY CARE, CHARTERED
Entity Type:Organization
Organization Name:SPECIAL THERAPY CARE, CHARTERED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANTILA
Authorized Official - Middle Name:LATOI
Authorized Official - Last Name:TERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MOT, OTR/L
Authorized Official - Phone:773-779-5800
Mailing Address - Street 1:11750 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-4732
Mailing Address - Country:US
Mailing Address - Phone:773-779-5800
Mailing Address - Fax:773-779-5573
Practice Address - Street 1:11750 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-4732
Practice Address - Country:US
Practice Address - Phone:773-779-5800
Practice Address - Fax:773-779-5573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-16
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL060009396252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency