Healthcare Provider Details

I. General information

NPI: 1922273952
Provider Name (Legal Business Name): THERAPY WORKS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2008
Last Update Date: 04/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21020 KOSTNER AVE
MATTESON IL
60443-2068
US

IV. Provider business mailing address

21020 KOSTNER AVE
MATTESON IL
60443-2068
US

V. Phone/Fax

Practice location:
  • Phone: 708-747-1300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number146007427
License Number StateIL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MS. REBECCA MANNY
Title or Position: SPEECH LANGUAGE PATHOLOGIST
Credential: M.S. CCC SLP
Phone: 708-747-1300