Healthcare Provider Details

I. General information

NPI: 1063273787
Provider Name (Legal Business Name): LIGHTHOUSE CHILDREN'S THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2024
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1209 IROQUOIS LN
DARIEN IL
60561-5028
US

IV. Provider business mailing address

1209 IROQUOIS LN
DARIEN IL
60561-5028
US

V. Phone/Fax

Practice location:
  • Phone: 630-674-3888
  • Fax:
Mailing address:
  • Phone: 630-674-3888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0008X
TaxonomyPediatric Neurodevelopmental Disabilities Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. MONICA CHEN
Title or Position: OCCUPATIONAL THERAPIST/OWNER
Credential: MOT
Phone: 630-674-3888