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Organization
LUMINATE THERAPY GROUP OF ILLINOIS, LLC
Active
Organization
LUMINATE THERAPY GROUP OF ILLINOIS, LLC
Active
Parent organization
LUMINATE THERAPY GROUP OF ILLINOIS, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
LUMINATE THERAPY GROUP OF ILLINOIS, LLC
Authorized official
TODD BOCK (PRESIDENT)
(512) 858-9900
Entity
Organization
Contact information
Practice address
580 SLAWIN COURT, MT. PROSPECT, IL 60056
(224) 612-8338
(512) 894-9901
Mailing address
7500 RIALTO BOULEVARD, BUILDING 1 SUITE 260, AUSTIN TX, TX 78735
(512) 858-9900
(512) 858-9901
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
02/01/2019
Last updated
02/01/2019
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