Healthcare Provider Details

I. General information

NPI: 1518099084
Provider Name (Legal Business Name): A PLACE FOR CHILDREN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 W PRATT BLVD
CHICAGO IL
60645-4665
US

IV. Provider business mailing address

3041 W NORTH SHORE AVE
CHICAGO IL
60645-4127
US

V. Phone/Fax

Practice location:
  • Phone: 847-208-7097
  • Fax: 775-269-9239
Mailing address:
  • Phone: 847-208-7097
  • Fax: 775-269-9239

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MR. RALPH F RUNIONS
Title or Position: BUSINESS MANAGER
Credential:
Phone: 219-331-4990