# THE TABOR THERAPY GROUP, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** TABOR THERAPY GROUP, INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1619596541
- **Legal business name:** TABOR THERAPY GROUP, INC
- **Authorized official:** ELLIOTT RICHELSON M.D. (CHIEF MEDICAL OFFICER)
- **Authorized official phone:** (941) 444-1730

## Contact information

- **Practice address:** 12151 REGENCY PKWY STE 12169, HUNTLEY, IL 60142-7644
- **Practice address phone:** (815) 331-8768
- **Mailing address:** 5404 W ELM ST STE H, MCHENRY, IL 60050-4007
- **Mailing address phone:** (815) 331-8768

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/10/2020
- **Last updated:** 05/03/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2B17-IPI-002 | — | IL |