Organization
BEYOND PLAY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LUCKY FERGUSON (MANAGING PARTNER)
(224) 201-8769
Entity
Organization
Contact information
Practice address
544 NUNDA TRL, CRYSTAL LAKE, IL 60012-3795
(224) 201-8769
(224) 324-8549
Mailing address
544 NUNDA TRL, CRYSTAL LAKE, IL 60012-3795
(224) 201-8769
(224) 324-8549
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
171R00000X
Interpreter
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
08/13/2019
Last updated
10/24/2024
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