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NPI Code Detail

MEDICARE: TRESTLE THERAPY GROUP, PLLC

MEDICARE: TRESTLE THERAPY GROUP, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1376267831
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRESTLE THERAPY GROUP, PLLC
Provider Business Mailing Address
First Line : 4560 W 103RD ST STE 2
Second Line :
City : OAK LAWN
State : IL
Zip : 60453-4870
Country : US
Telephone Number : 708-581-5798
Fax Number :
Provider Business Practice Location Address
First Line : 4560 W 103RD ST STE 2
Second Line :
City : OAK LAWN
State : IL
Zip : 60453-4870
Country : US
Telephone Number : 708-581-5798
Fax Number :
Authorized Official
Title or Position : MEMBER, MANAGER
Name : MRS. MAUREEN COONEY
Credential : MS, CCC-SLP, COM
Telephone Number : 773-841-8180
Provider Enumeration Date : 09/28/2022
Last Update Date : 10/05/2022

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Directions to “TRESTLE THERAPY GROUP, PLLC ” Practice Location

Language Start Address Practice Location
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