Healthcare Provider Details

I. General information

NPI: 1093358954
Provider Name (Legal Business Name): INSPIRE THERAPEUTIC SERVICES. PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2019
Last Update Date: 06/03/2022
Certification Date: 06/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2135 CITY GATE LN STE 300
NAPERVILLE IL
60563
US

IV. Provider business mailing address

PO BOX 584
NORTH AURORA IL
60542-0140
US

V. Phone/Fax

Practice location:
  • Phone: 630-755-5300
  • Fax: 331-236-0370
Mailing address:
  • Phone: 630-755-5300
  • Fax: 331-236-0370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MR. KEVIN P SPRENKLE
Title or Position: EXECUTIVE DIRECTOR
Credential: PSY.D
Phone: 630-755-5300