=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336284876
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PURPOSEFUL PLAY, INC,
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/21/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1910 S STATE ST APT 232
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60616-4424
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 773-330-9348
-----------------------------------------------------
Fax | 773-913-6188
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1910 S STATE ST APT 232
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60616-4424
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 773-330-9348
-----------------------------------------------------
Fax | 773-913-6188
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | RHONDA SCHLEIS
-----------------------------------------------------
Credential | OTR
-----------------------------------------------------
Telephone | 773-330-9348
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225XP0200X
-----------------------------------------------------
Taxonomy Name | Pediatric Occupational Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------