=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417279209
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JUST FOR U
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/19/2010
-----------------------------------------------------
Last Update Date | 02/19/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 839 N KILDARE AVE
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60651-3530
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 773-600-1765
-----------------------------------------------------
Fax | 708-260-9448
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 839 N KILDARE AVE
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60651-3530
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax | 708-260-9448
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MARGARET CRAFT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 708-600-1765
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 252Y00000X
-----------------------------------------------------
Taxonomy Name | Early Intervention Provider Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------