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Organization
EASTER SEALS DUPAGE AND THE FOX VALLEY REGION
Active
Organization
EASTER SEALS DUPAGE AND THE FOX VALLEY REGION
Active
Other names
Easter Seals DuPage, Easterseals DuPage & Fox Valley
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA FORTHOFER (PRESIDENT/CEO)
(630) 620-4433
Entity
Organization
Contact information
Practice address
830 S. ADDISON AVENUE, VILLA PARK, IL 60181
(630) 620-4433
(630) 620-1148
Mailing address
830 S. ADDISON AVENUE, VILLA PARK, IL 60181-2877
(630) 620-4433
(630) 620-1148
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
—
NULL
103TB0200X
Cognitive & Behavioral Psychologist
—
—
104100000X
Social Worker
—
NULL
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
133N00000X
Nutritionist
—
NULL
133N00000X
Nutritionist
—
—
133V00000X
Registered Dietitian
—
NULL
133V00000X
Registered Dietitian
—
—
2080P0006X
Developmental - Behavioral Pediatrics Physician
—
NULL
2080P0006X
Developmental - Behavioral Pediatrics Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
—
—
222Q00000X
Developmental Therapist
—
NULL
222Q00000X
Developmental Therapist
—
—
225100000X
Physical Therapist
Primary
—
NULL
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
NULL
225X00000X
Occupational Therapist
—
—
231H00000X
Audiologist
—
NULL
231H00000X
Audiologist
—
—
235Z00000X
Speech-Language Pathologist
—
NULL
235Z00000X
Speech-Language Pathologist
—
—
261QA3000X
Augmentative Communication Clinic/Center
—
NULL
261QD1600X
Developmental Disabilities Clinic/Center
—
NULL
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02215165
BLUE CROSS BLUE SHIELD GROUP
IL
Enumeration date
07/12/2005
Last updated
09/17/2024
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