Healthcare Provider Details

I. General information

NPI: 1003066374
Provider Name (Legal Business Name): TINY STEPS THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2008
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

483 W 2ND ST
ELMHURST IL
60126-2509
US

IV. Provider business mailing address

483 W 2ND ST
ELMHURST IL
60126-2509
US

V. Phone/Fax

Practice location:
  • Phone: 630-709-3149
  • Fax:
Mailing address:
  • Phone: 630-709-3149
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: CAROL KOSTELNY
Title or Position: PRESIDENT
Credential: DPT
Phone: 630-709-3149