Provider Demographics
NPI:1972007029
Name:THRIVE THERAPIES IL INC
Entity Type:Organization
Organization Name:THRIVE THERAPIES IL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:PAULINA
Authorized Official - Middle Name:
Authorized Official - Last Name:POLEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-659-3241
Mailing Address - Street 1:400 S DRYDEN PL
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-2136
Mailing Address - Country:US
Mailing Address - Phone:224-659-3241
Mailing Address - Fax:773-249-1235
Practice Address - Street 1:400 S DRYDEN PL
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2136
Practice Address - Country:US
Practice Address - Phone:224-659-3241
Practice Address - Fax:773-249-1235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-22
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146012970235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty