Healthcare Provider Details

I. General information

NPI: 1679927222
Provider Name (Legal Business Name): CHILD THERAPY AND REHABILITATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2016
Last Update Date: 09/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

790 FLETCHER DR UNIT 101
ELGIN IL
60123-4755
US

IV. Provider business mailing address

1725 FREMONT CT
HOFFMAN ESTATES IL
60169-4325
US

V. Phone/Fax

Practice location:
  • Phone: 847-697-7800
  • Fax: 847-697-7807
Mailing address:
  • Phone: 847-736-2481
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. CHRISTINA L PEYSER
Title or Position: CLINICAL DIRECTOR & OWNER
Credential: MBA
Phone: 847-697-7800