Healthcare Provider Details
I. General information
NPI: 1528962719
Provider Name (Legal Business Name): THIRD THREAD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1130 S CANAL ST STE 1400
CHICAGO IL
60607-5058
US
IV. Provider business mailing address
1130 S CANAL ST STE 1400
CHICAGO IL
60607-5058
US
V. Phone/Fax
- Phone: 312-971-7474
- Fax:
- Phone: 312-971-7474
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | |
| License Number State | NULL |
VIII. Authorized Official
Name: MS.
VANESSA
TERCERO
Title or Position: OWNER
Credential: LMFT
Phone: 312-971-7474