Healthcare Provider Details

I. General information

NPI: 1831104520
Provider Name (Legal Business Name): KIDS THERAPY, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1860 W WINCHESTER RD SUITE 108
LIBERTYVILLE IL
60048-5351
US

IV. Provider business mailing address

1860 W WINCHESTER RD SUITE 108
LIBERTYVILLE IL
60048-5351
US

V. Phone/Fax

Practice location:
  • Phone: 847-573-9486
  • Fax: 847-549-6139
Mailing address:
  • Phone: 847-573-9486
  • Fax: 847-549-6139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateIL

VIII. Authorized Official

Name: JAMES MORETTINI
Title or Position: CFO
Credential:
Phone: 847-573-9486