Provider Demographics
NPI:1134550775
Name:ATTUNE THERAPY, INC.
Entity type:Organization
Organization Name:ATTUNE THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:MAY
Authorized Official - Last Name:GOUDSCHAAL
Authorized Official - Suffix:
Authorized Official - Credentials:MOTR/L
Authorized Official - Phone:847-602-0080
Mailing Address - Street 1:2034 N MOHAWK ST UNIT 3
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-4515
Mailing Address - Country:US
Mailing Address - Phone:847-602-0080
Mailing Address - Fax:
Practice Address - Street 1:2034 N MOHAWK ST UNIT 3
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-4515
Practice Address - Country:US
Practice Address - Phone:847-602-0080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-09
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056-005426174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL358235OtherBCBS