Healthcare Provider Details

I. General information

NPI: 1982476180
Provider Name (Legal Business Name): THERAPYWORKS AUTISM SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2023
Last Update Date: 10/23/2023
Certification Date: 10/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

778 W FRONTAGE RD STE 101
NORTHFIELD IL
60093-1209
US

IV. Provider business mailing address

545 LINCOLN AVE STE 4
WINNETKA IL
60093-2349
US

V. Phone/Fax

Practice location:
  • Phone: 312-780-0820
  • Fax:
Mailing address:
  • Phone: 312-287-4900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: ERIN VOLLMER
Title or Position: CO-CEO AND CO-FOUNDER
Credential: MS, CCC-SLP
Phone: 312-287-4900