Healthcare Provider Details

I. General information

NPI: 1760702849
Provider Name (Legal Business Name): EDULOGOS LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2010
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4515 N MILWAUKEE AVE
CHICAGO IL
60630-3711
US

IV. Provider business mailing address

4515 N MILWAUKEE AVE
CHICAGO IL
60630-3711
US

V. Phone/Fax

Practice location:
  • Phone: 773-656-3016
  • Fax: 773-729-2232
Mailing address:
  • Phone: 773-656-3016
  • Fax: 773-729-2232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. MAGDALENA MARSZALEK
Title or Position: PRESIDENT
Credential:
Phone: 312-671-4111