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1265699110 NPI number — BUILDING BLOCKS THERAPY, LTD.

NPI Number: 1265699110
Health Care Provider/Practitioner: BUILDING BLOCKS THERAPY, LTD.

Information about “1265699110” NPI (BUILDING BLOCKS THERAPY, LTD.) exists in 1265699110 in HTML format HTML  |  1265699110 in plain Text format TXT  |  1265699110 in PDF (Portable Document Format) PDF  |  1265699110 in an XML format XML  formats.

NPI Number : 1265699110 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1265699110",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "BUILDING BLOCKS THERAPY, LTD.",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "643 THOMPSON AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "NORTH AURORA",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60542-9128",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "847-343-8109",
    "MailingAddressFaxNumber": "630-701-2327",
    "FirstLinePracticeLocationAddress": "415 WILLIAMSBURG AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GENEVA",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "60134-1091",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "331-248-0251",
    "PracticeLocationAddressFaxNumber": "331-248-0252",
    "EnumerationDate": "05/19/2008",
    "LastUpdateDate": "12/19/2016",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "WASSERBERG",
    "AuthorizedOfficialFirstName": "SARAH",
    "AuthorizedOfficialMiddleName": "A",
    "AuthorizedOfficialTitle": "OWNER/SPEECH LANGAUGE PATHOLOGIST",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MA CCC-SLP/L",
    "AuthorizedOfficialTelephoneNumber": "847-343-8109",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "252Y00000X",
        "TaxonomyName": "Early Intervention Provider Agency",
        "LicenseNumber": "146006763",
        "LicenseNumberStateCode": "IL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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