Healthcare Provider Details

I. General information

NPI: 1194526319
Provider Name (Legal Business Name): COLOR ALONG PEDIATRIC THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2025
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9651 W 153RD ST STE 58
ORLAND PARK IL
60462-4601
US

IV. Provider business mailing address

9651 W 153RD ST STE 58
ORLAND PARK IL
60462-4601
US

V. Phone/Fax

Practice location:
  • Phone: 630-320-6904
  • Fax:
Mailing address:
  • Phone: 630-320-6904
  • Fax: 630-566-4153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MS. MUNIRA ABDULQADIR BADRI
Title or Position: OWNER/CLINICAL DIRECTOR
Credential: OTR/L
Phone: 630-320-6904