MEDICARE: THRIVE THERAPIES IL INC

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	235Z00000X	Speech-Language Pathologist	146012970	IL

General Provider Information

NPI Number	:	1972007029
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THRIVE THERAPIES IL INC

Provider Business Mailing Address
First Line	:	400 S DRYDEN PL
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-2136
Country	:	US
Telephone Number	:	224-659-3241
Fax Number	:	773-249-1235

Provider Business Practice Location Address
First Line	:	400 S DRYDEN PL
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-2136
Country	:	US
Telephone Number	:	224-659-3241
Fax Number	:	773-249-1235

Authorized Official
Title or Position	:	SECRETARY
Name	:	PAULINA POLEK
Credential	:
Telephone Number	:	224-659-3241

Provider Enumeration Date	:	03/22/2018
Last Update Date	:	03/22/2018

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Directions to “THRIVE THERAPIES IL INC ” Practice Location

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