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NPI Code Detail

MEDICARE: PEDIATRIC THERAPY SPECIALISTS PLLC

MEDICARE: PEDIATRIC THERAPY SPECIALISTS 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
1222Q00000XDevelopmental Therapist
2225XP0200XPediatric Occupational Therapist

General Provider Information

NPI Number : 1912761420
Entity Type Code : Organization
Provider Name (Legal Business Name) : PEDIATRIC THERAPY SPECIALISTS PLLC
Provider Business Mailing Address
First Line : 14 FAWN RIDGE DR
Second Line :
City : OAKWOOD HILLS
State : IL
Zip : 60013-1069
Country : US
Telephone Number : 847-312-6421
Fax Number :
Provider Business Practice Location Address
First Line : 14 FAWN RIDGE DR
Second Line :
City : OAKWOOD HILLS
State : IL
Zip : 60013-1069
Country : US
Telephone Number : 847-312-6421
Fax Number :
Authorized Official
Title or Position : OCCUPATIONAL THERAPIST
Name : MRS. MARIA PASSARO
Credential : OTR/L
Telephone Number : 847-312-6421
Provider Enumeration Date : 02/06/2024
Last Update Date : 01/23/2026

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