Organization
THE TABOR THERAPY GROUP, INC
Active
Parent organization
TABOR THERAPY GROUP, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
TABOR THERAPY GROUP, INC
Authorized official
ELLIOTT RICHELSON M.D. (CHIEF MEDICAL OFFICER)
(941) 444-1730
Entity
Organization
Contact information
Practice address
12151 REGENCY PKWY STE 12169, HUNTLEY, IL 60142-7644
(815) 331-8768
Mailing address
5404 W ELM ST STE H, MCHENRY, IL 60050-4007
(815) 331-8768
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2B17-IPI-002
—
IL
Enumeration date
04/10/2020
Last updated
05/03/2022
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