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NPI Code Detail

MEDICARE: BLUE BIRD DAY LLC

MEDICARE: BLUE BIRD DAY 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
12251P0200XPediatric Physical TherapistIL
2222Q00000XDevelopmental TherapistIL
3225XP0200XPediatric Occupational TherapistIL
4235Z00000XSpeech-Language PathologistIL
5261QM1300XMulti-Specialty Clinic/Center

General Provider Information

NPI Number : 1588030621
Entity Type Code : Organization
Provider Name (Legal Business Name) : BLUE BIRD DAY LLC
Provider Business Mailing Address
First Line : 1233 W ADAMS ST
Second Line :
City : CHICAGO
State : IL
Zip : 60607-2801
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1233 W ADAMS ST
Second Line :
City : CHICAGO
State : IL
Zip : 60607-2801
Country : US
Telephone Number : 312-733-0883
Fax Number :
Authorized Official
Title or Position : OWNER
Name : LAURA H MRAZ
Credential : OTD
Telephone Number : 312-733-0883
Provider Enumeration Date : 08/12/2015
Last Update Date : 04/15/2026

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Directions to “BLUE BIRD DAY LLC ” Practice Location

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