MEDICARE: E I FOR 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

General Provider Information

NPI Number	:	1457583569
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	E I FOR TOTS INC,

Provider Business Mailing Address
First Line	:	4800 S CHICAGO BEACH DR
Second Line	:	#1701 SO.
City	:	CHICAGO
State	:	IL
Zip	:	60615-7032
Country	:	US
Telephone Number	:	773-268-3140
Fax Number	:

Provider Business Practice Location Address
First Line	:	4800 S CHICAGO BEACH DR
Second Line	:	#1701 SO.
City	:	CHICAGO
State	:	IL
Zip	:	60615-7032
Country	:	US
Telephone Number	:	773-268-3140
Fax Number	:

Authorized Official
Title or Position	:	DEVELOPMENTAL THERAPIST
Name	:	VIVIAN MARIE HEMBY
Credential	:	M.A HUMAN SERVICES
Telephone Number	:	773-507-4416

Provider Enumeration Date	:	08/23/2009
Last Update Date	:	08/23/2009

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