Healthcare Provider Details

I. General information

NPI: 1154225845
Provider Name (Legal Business Name): PLAY TOGETHER THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

168 WELLINGTON DR
CRYSTAL LAKE IL
60014-7870
US

IV. Provider business mailing address

168 WELLINGTON DR
CRYSTAL LAKE IL
60014-7870
US

V. Phone/Fax

Practice location:
  • Phone: 815-353-3538
  • Fax:
Mailing address:
  • Phone: 815-353-3538
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: STACY DE CRISTOFARO
Title or Position: DEVELOPMENTAL THERAPIST/OWNER
Credential: B.A.
Phone: 815-353-3538