MEDICARE: THERAPY TOTS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	252Y00000X	Early Intervention Provider Agency	056.004143	IL

General Provider Information

NPI Number	:	1083920789
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERAPY TOTS, INC.

Provider Business Mailing Address
First Line	:	1157 W NEWPORT AVE UNIT C
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-1500
Country	:	US
Telephone Number	:	773-549-6641
Fax Number	:

Provider Business Practice Location Address
First Line	:	1157 W NEWPORT AVE UNIT C
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-1500
Country	:	US
Telephone Number	:	773-549-6641
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KRISTY A ZARLEY
Credential	:
Telephone Number	:	773-549-6641

Provider Enumeration Date	:	08/19/2010
Last Update Date	:	08/19/2010

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