Healthcare Provider Details

I. General information

NPI: 1710717285
Provider Name (Legal Business Name): THE THRESHOLDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2024
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

616 S IL ROUTE 31
MCHENRY IL
60050-8269
US

IV. Provider business mailing address

4101 N RAVENSWOOD AVE
CHICAGO IL
60613-2193
US

V. Phone/Fax

Practice location:
  • Phone: 773-572-5500
  • Fax:
Mailing address:
  • Phone: 773-572-5480
  • Fax: 773-572-5240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARCELLA KLAUER
Title or Position: EXECUTIVE ASSISTANT, QUALITY
Credential:
Phone: 773-572-5480