MEDICARE: JUMP FOR JOY THERAPY SERVICES 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	222Q00000X	Developmental Therapist
2	252Y00000X	Early Intervention Provider Agency

General Provider Information

NPI Number	:	1639619950
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JUMP FOR JOY THERAPY SERVICES INC

Provider Business Mailing Address
First Line	:	1122 PORT ROYAL RD
Second Line	:
City	:	PINGREE GROVE
State	:	IL
Zip	:	60140-9196
Country	:	US
Telephone Number	:	224-639-5018
Fax Number	:	888-759-8569

Provider Business Practice Location Address
First Line	:	1122 PORT ROYAL RD
Second Line	:
City	:	PINGREE GROVE
State	:	IL
Zip	:	60140-9196
Country	:	US
Telephone Number	:	224-639-5018
Fax Number	:	888-759-8569

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. AMY LYNN VILLARREAL
Credential	:
Telephone Number	:	224-639-5018

Provider Enumeration Date	:	03/06/2017
Last Update Date	:	02/06/2026

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