=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609907187
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DB KIDS THERAPY SERVICES, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/08/2007
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7835 N 1430TH ST
-----------------------------------------------------
City | EFFINGHAM
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 62401-7190
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 217-536-5941
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7835 N 1430TH ST
-----------------------------------------------------
City | EFFINGHAM
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 62401-7190
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 217-536-5941
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DEENA BUSHUE
-----------------------------------------------------
Credential | SLP
-----------------------------------------------------
Telephone | 217-536-5941
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2355S0801X
-----------------------------------------------------
Taxonomy Name | Speech-Language Assistant
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------