NPI Code Details Logo

NPI 1588544340

NPI 1588544340 : THERA ORA PLLC : GURNEE, IL

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1588544340
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    THERA ORA PLLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    09/03/2025
-----------------------------------------------------
    Last Update Date     |    09/04/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    7446 CLAREWOOD LN 
-----------------------------------------------------
    City                 |    GURNEE
-----------------------------------------------------
    State                |    IL
-----------------------------------------------------
    Zip                  |    60031-5339
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    847-999-3119
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    7446 CLAREWOOD LN 
-----------------------------------------------------
    City                 |    GURNEE
-----------------------------------------------------
    State                |    IL
-----------------------------------------------------
    Zip                  |    60031-5339
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    847-999-3119
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    OWNER
-----------------------------------------------------
    Name                 |     DALIA  VAISAITE 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    847-999-3119
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    261QM0855X
-----------------------------------------------------
    Taxonomy Name        |    Adolescent and Children Mental Health Clinic/Center
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    103T00000X
-----------------------------------------------------
    Taxonomy Name        |    Psychologist
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
    Taxonomy Code        |    1041C0700X
-----------------------------------------------------
    Taxonomy Name        |    Clinical Social Worker
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
    Taxonomy Code        |    261QD1600X
-----------------------------------------------------
    Taxonomy Name        |    Developmental Disabilities Clinic/Center
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #5
-----------------------------------------------------
    Taxonomy Code        |    101YP2500X
-----------------------------------------------------
    Taxonomy Name        |    Professional Counselor
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #6
-----------------------------------------------------
    Taxonomy Code        |    261QM0850X
-----------------------------------------------------
    Taxonomy Name        |    Adult Mental Health Clinic/Center
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #7
-----------------------------------------------------
    Taxonomy Code        |    101YM0800X
-----------------------------------------------------
    Taxonomy Name        |    Mental Health Counselor
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #8
-----------------------------------------------------
    Taxonomy Code        |    103TC0700X
-----------------------------------------------------
    Taxonomy Name        |    Clinical Psychologist
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #9
-----------------------------------------------------
    Taxonomy Code        |    106H00000X
-----------------------------------------------------
    Taxonomy Name        |    Marriage & Family Therapist
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.