MEDICARE: SHINE EARLY LTD

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	1041C0700X	Clinical Social Worker
2	171R00000X	Interpreter
3	222Q00000X	Developmental Therapist
4	235Z00000X	Speech-Language Pathologist
5	224Z00000X	Occupational Therapy Assistant
6	225100000X	Physical Therapist
7	225X00000X	Occupational Therapist
8	252Y00000X	Early Intervention Provider Agency

General Provider Information

NPI Number	:	1588533772
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHINE EARLY LTD

Provider Business Mailing Address
First Line	:	1056 FLORIDA LN
Second Line	:
City	:	ELK GROVE VILLAGE
State	:	IL
Zip	:	60007-2958
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1056 FLORIDA LN
Second Line	:
City	:	ELK GROVE VILLAGE
State	:	IL
Zip	:	60007-2958
Country	:	US
Telephone Number	:	312-671-4111
Fax Number	:

Authorized Official
Title or Position	:	SPEECH PATHOLOGIST/ OWNER
Name	:	MAGDALENA MARSZALEK
Credential	:	SLP/L
Telephone Number	:	312-671-4111

Provider Enumeration Date	:	11/04/2025
Last Update Date	:	11/04/2025

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Directions to “SHINE EARLY LTD ” Practice Location

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