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NPI Code Detail

MEDICARE: MIGHTY KIDS PEDIATRIC THERAPY, PLLC

MEDICARE: MIGHTY KIDS PEDIATRIC THERAPY, 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 : 1548115660
Entity Type Code : Organization
Provider Name (Legal Business Name) : MIGHTY KIDS PEDIATRIC THERAPY, PLLC
Provider Business Mailing Address
First Line : 213 W INSTITUTE PL STE 210
Second Line :
City : CHICAGO
State : IL
Zip : 60610-3196
Country : US
Telephone Number : 847-899-1030
Fax Number :
Provider Business Practice Location Address
First Line : 213 W INSTITUTE PL STE 210
Second Line :
City : CHICAGO
State : IL
Zip : 60610-3196
Country : US
Telephone Number : 847-242-1222
Fax Number :
Authorized Official
Title or Position : SPEECH-LANGUAGE PATHOLOGIST
Name : MRS. AUNDREA SKOULLOS
Credential : CCC-SLP, CLC
Telephone Number : 847-899-1030
Provider Enumeration Date : 03/03/2026
Last Update Date : 03/03/2026

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Directions to “MIGHTY KIDS PEDIATRIC THERAPY, PLLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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