MEDICARE: PATHWAYS THERAPEUTIC SERVICES 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1982068318
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATHWAYS THERAPEUTIC SERVICES INC.

Provider Business Mailing Address
First Line	:	PO BOX 1006
Second Line	:
City	:	FRANKFORT
State	:	IL
Zip	:	60423-7006
Country	:	US
Telephone Number	:	815-260-6422
Fax Number	:

Provider Business Practice Location Address
First Line	:	15255 S 94TH AVE
Second Line	:	SUITE 500
City	:	ORLAND PARK
State	:	IL
Zip	:	60462-3800
Country	:	US
Telephone Number	:	815-260-6422
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	BRIDGET BORRELLI
Credential	:	BCBA
Telephone Number	:	815-260-6422

Provider Enumeration Date	:	04/12/2016
Last Update Date	:	04/12/2016

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