Provider Demographics
NPI:1770156994
Name:PLAYFUL PEDIATRICS LLC
Entity type:Organization
Organization Name:PLAYFUL PEDIATRICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARY KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KUCHTA
Authorized Official - Suffix:
Authorized Official - Credentials:MS, OTR/L
Authorized Official - Phone:708-805-0173
Mailing Address - Street 1:21201 S ELSNER RD
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-4730
Mailing Address - Country:US
Mailing Address - Phone:708-805-0173
Mailing Address - Fax:708-694-7008
Practice Address - Street 1:21201 S ELSNER RD UNIT 3
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-4501
Practice Address - Country:US
Practice Address - Phone:708-805-0173
Practice Address - Fax:708-694-7008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-24
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty