MEDICARE: THRIVE THERAPEUTIC SERVICES, LLC

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	101YP1600X	Pastoral Counselor	178004019	IL
2	1041C0700X	Clinical Social Worker	149013183	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	1104058114	OTHER	OWNER NPI
2	12026361	OTHER	CAQH
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568694578
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THRIVE THERAPEUTIC SERVICES, LLC

Provider Business Mailing Address
First Line	:	200 E EVERGREEN AVE STE 106
Second Line	:
City	:	MOUNT PROSPECT
State	:	IL
Zip	:	60056-3240
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 E EVERGREEN AVE STE 106
Second Line	:
City	:	MOUNT PROSPECT
State	:	IL
Zip	:	60056-3240
Country	:	US
Telephone Number	:	847-749-3807
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KATHLEEN ERIN ECCLES
Credential	:
Telephone Number	:	847-749-3807

Provider Enumeration Date	:	08/10/2009
Last Update Date	:	12/07/2023

Similar Medicare Providers

1467316976 — MADELINE C BORATTO LSW
Practice Location Address:

200 E EVERGREEN AVE STE 106
MOUNT PROSPECT, IL
60056-3240

Practice Phone: 847-749-3807
Practice Fax: 224-478-0807

1447285960 — MS. CAROL ANN ZIOLO RN, LCPC
Practice Location Address:

200 E EVERGREEN AVE , SUITE 102
MT PROSPECT, IL
60056-3240

Practice Phone: 847-651-8553
Practice Fax:

1871757807 — RUSSEL LEE SKYLES D.D.S.
Practice Location Address:

200 E EVERGREEN AVE , SUITE 129
MT PROSPECT, IL
60056-3240

Practice Phone: 847-259-7560
Practice Fax: 847-259-0808

1154553105 — PETER LUND D.D.S.
Practice Location Address:

200 E EVERGREEN AVE
MT PROSPECT, IL
60056-3240

Practice Phone: 847-253-8350
Practice Fax:

1891132130 — DR. PAMELA RUFFER, P.C.
Practice Location Address:

200 E EVERGREEN AVE
MT PROSPECT, IL
60056-3240

Practice Phone: 630-539-0217
Practice Fax:

1306246566 — PBR FAMILY CONSULTING, INC.
Practice Location Address:

200 E EVERGREEN AVE STE 112
MOUNT PROSPECT, IL
60056-3240

Practice Phone: 847-255-4055
Practice Fax: 847-577-5066

Directions to “THRIVE THERAPEUTIC SERVICES, LLC ” 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.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.