Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
PEDIASOURCE THERAPY SPECIALISTS
Active
Organization
PEDIASOURCE THERAPY SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HEMA RAJ TRUKENBROD OTRL (PRESIDENT)
(773) 988-9905
Entity
Organization
Contact information
Practice address
2530 N LINCOLN AVE STE 114, CHICAGO, IL 60614-2479
(773) 988-9905
(773) 404-1774
Mailing address
1872 N CLYBOURN AVE APT 111, CHICAGO, IL 60614-4916
(773) 988-9905
(773) 404-1774
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
2251P0200X
Pediatric Physical Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
05/10/2007
Last updated
09/11/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up