Healthcare Provider Details

I. General information

NPI: 1720098734
Provider Name (Legal Business Name): THERAPEDIATRICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 LAKEVIEW PKWY STE 180
VERNON HILLS IL
60061-1850
US

IV. Provider business mailing address

400 LAKEVIEW PARKWAY STE 180
VERNON HILLS IL
60061-1803
US

V. Phone/Fax

Practice location:
  • Phone: 847-996-6666
  • Fax: 847-996-6665
Mailing address:
  • Phone: 847-996-6666
  • Fax: 847-996-6665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: DANA KNAPP
Title or Position: OPERATIONS MANAGER
Credential:
Phone: 847-996-6666