Healthcare Provider Details

I. General information

NPI: 1114995263
Provider Name (Legal Business Name): THERAPEUTIC & WELLNESS SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

480 ELM PL SUITE 103
HIGHLAND PARK IL
60035-2538
US

IV. Provider business mailing address

480 ELM PL SUITE 103
HIGHLAND PARK IL
60035-2538
US

V. Phone/Fax

Practice location:
  • Phone: 847-926-9355
  • Fax: 847-926-8955
Mailing address:
  • Phone: 847-926-9355
  • Fax: 847-926-8955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251E1200X
TaxonomyErgonomics Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. JANE FERRY
Title or Position: GENERAL MANAGER
Credential:
Phone: 847-926-9355