Healthcare Provider Details

I. General information

NPI: 1790571131
Provider Name (Legal Business Name): SMART START PARENTING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2025
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

341 N STONE AVE
LA GRANGE PARK IL
60526-1818
US

IV. Provider business mailing address

341 N STONE AVE
LA GRANGE PARK IL
60526-1818
US

V. Phone/Fax

Practice location:
  • Phone: 708-645-6163
  • Fax:
Mailing address:
  • Phone: 708-645-6163
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: KRISTEN J FRAYN
Title or Position: OCCUPATIONAL THERAPIST
Credential: OTR/L
Phone: 708-645-6163