Healthcare Provider Details

I. General information

NPI: 1497727143
Provider Name (Legal Business Name): THERAPEDS INTERVENTION SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2006
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1409 N RIDGEWAY AVE
CHICAGO IL
60651-2160
US

IV. Provider business mailing address

1409 N RIDGEWAY AVE
CHICAGO IL
60651-2160
US

V. Phone/Fax

Practice location:
  • Phone: 773-818-3535
  • Fax: 866-391-1051
Mailing address:
  • Phone: 773-818-3535
  • Fax: 866-391-1051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number070-011157
License Number StateIL
# 5
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. HOA TU
Title or Position: FOUNDER/PHYSICAL THERAPIST
Credential: PT
Phone: 773-818-3535