# EASTER SEALS DUPAGE AND THE FOX VALLEY REGION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Easter Seals DuPage, Easterseals DuPage & Fox Valley
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568460681
- **Authorized official:** THERESA FORTHOFER (PRESIDENT/CEO)
- **Authorized official phone:** (630) 620-4433

## Contact information

- **Practice address:** 830 S. ADDISON AVENUE, VILLA PARK, IL 60181
- **Practice address phone:** (630) 620-4433
- **Practice address fax:** (630) 620-1148
- **Mailing address:** 830 S. ADDISON AVENUE, VILLA PARK, IL 60181-2877
- **Mailing address phone:** (630) 620-4433
- **Mailing address fax:** (630) 620-1148

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 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

- **Enumeration date:** 07/12/2005
- **Last updated:** 09/17/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 02215165 | BLUE CROSS BLUE SHIELD GROUP | IL |