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Organization
THE THERAPY TREE D.B.A. BIRTH TO THREE & BEYOND PEDIATRIC THERAPIES
Active
Organization
THE THERAPY TREE D.B.A. BIRTH TO THREE & BEYOND PEDIATRIC THERAPIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARIN RICHTER (OFFICE MANAGER)
(847) 265-7300
Entity
Organization
Contact information
Practice address
89 CEDAR AVE, LAKE VILLA, IL 60046-8411
(847) 265-7300
(847) 265-7301
Mailing address
PO BOX 764, LAKE VILLA, IL 60046-0764
(847) 265-7300
(847) 265-7301
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
178003554
IL
101YM0800X
Mental Health Counselor
180004644
IL
174400000X
Specialist
056005900
IL
174400000X
Specialist
056006553
IL
174400000X
Specialist
056007775
IL
174400000X
Specialist
070002049
IL
174400000X
Specialist
070010601
IL
174400000X
Specialist
070014701
IL
235Z00000X
Speech-Language Pathologist
Primary
146005107
IL
235Z00000X
Speech-Language Pathologist
242000307
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04932271
BLUE SHIELD PROVIDER
IL
Enumeration date
12/11/2006
Last updated
09/13/2010
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