MEDICARE: THERAPEUTIC INTERVENTION FOR KIDS AND ADULTS

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
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1457405110
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERAPEUTIC INTERVENTION FOR KIDS AND ADULTS

Provider Business Mailing Address
First Line	:	1327 W 32ND PL
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60608-6304
Country	:	US
Telephone Number	:	773-847-3232
Fax Number	:	773-847-3464

Provider Business Practice Location Address
First Line	:	1327 W 32ND PL
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60608-6304
Country	:	US
Telephone Number	:	773-847-3232
Fax Number	:	773-847-3464

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. IREK FILLIPIAK
Credential	:
Telephone Number	:	773-846-3232

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	08/22/2020

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