Healthcare Provider Details

I. General information

NPI: 1114101532
Provider Name (Legal Business Name): MEETING MILESTONES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2007
Last Update Date: 12/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3422 W 73RD PL
CHICAGO IL
60629-3514
US

IV. Provider business mailing address

3422 W 73RD PL
CHICAGO IL
60629-3514
US

V. Phone/Fax

Practice location:
  • Phone: 773-206-7122
  • Fax: 773-298-8395
Mailing address:
  • Phone: 773-206-7122
  • Fax: 773-288-8395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: KEENA HOYLE
Title or Position: CEO
Credential: OT
Phone: 773-206-7122