Provider Demographics
NPI:1801642913
Name:GROWING PLACES PEDIATRIC THERAPY PLLC
Entity type:Organization
Organization Name:GROWING PLACES PEDIATRIC THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST/ OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:FERGUSON REED
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:708-325-3320
Mailing Address - Street 1:7627 LAKE STREET, STE. 206., #A132
Mailing Address - Street 2:
Mailing Address - City:RIVER FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60305
Mailing Address - Country:US
Mailing Address - Phone:708-325-3320
Mailing Address - Fax:708-607-6973
Practice Address - Street 1:527 SELBORNE ROAD
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:IL
Practice Address - Zip Code:60546
Practice Address - Country:US
Practice Address - Phone:708-325-3320
Practice Address - Fax:708-607-6973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-29
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty