Provider Demographics
NPI:1255400255
Name:CHICAGOLAND EARLY INTERVENTION LTD
Entity type:Organization
Organization Name:CHICAGOLAND EARLY INTERVENTION LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PRAKASH
Authorized Official - Middle Name:C
Authorized Official - Last Name:NAVNI
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:708-535-0933
Mailing Address - Street 1:31 PINE NEEDLES DR
Mailing Address - Street 2:
Mailing Address - City:LEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60439-7741
Mailing Address - Country:US
Mailing Address - Phone:708-296-2209
Mailing Address - Fax:708-393-4681
Practice Address - Street 1:6006 159TH STREET
Practice Address - Street 2:BUILDING-B, 2ND FLOOR
Practice Address - City:OAK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60452-2904
Practice Address - Country:US
Practice Address - Phone:708-535-0933
Practice Address - Fax:708-614-9435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL57000083224Z00000X
IL57000485224Z00000X
IL57000991224Z00000X
IL225100000X, 225100000X, 225100000X, 225200000X, 225X00000X, 225X00000X, 2355S0801X, 235Z00000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========OtherFEIN NUMBER