Healthcare Provider Details

I. General information

NPI: 1699644377
Provider Name (Legal Business Name): PLAY4PURPOSE PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2025
Last Update Date: 11/01/2025
Certification Date: 11/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9303 WHITEHALL LN
ORLAND PARK IL
60462-7772
US

IV. Provider business mailing address

9303 WHITEHALL LN
ORLAND PARK IL
60462-7772
US

V. Phone/Fax

Practice location:
  • Phone: 331-643-3771
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY FAIRLEY
Title or Position: OCCUPATIONAL THERAPIST
Credential: MOT, OTR/L
Phone: 331-643-3771