The Tabor Therapy Group, Inc.

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

THE TABOR THERAPY GROUP, INC.

Practice address

5404 W Elm St Ste H
McHenry, IL 60050-4007

Phone

(815) 331-8768

Fax

(815) 331-8760

NPI assigned

May 25, 2017

Last updated

May 3, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

THE TABOR THERAPY GROUP, INC.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Elliott Richelson, M.D.

Title

Chief Medical Officer

Phone

(941) 444-1730

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

The Tabor Therapy Group Inc

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1495670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651536000000",
    "number": "1023546710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5404 W ELM ST STE H",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600504007",
            "telephone_number": "815-331-8768",
            "fax_number": "815-331-8760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5404 W ELM ST STE H",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600504007",
            "telephone_number": "815-331-8768",
            "fax_number": "815-331-8760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE TABOR THERAPY GROUP, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE TABOR THERAPY GROUP, INC.",
        "enumeration_date": "2017-05-25",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A",
        "authorized_official_last_name": "RICHELSON",
        "authorized_official_first_name": "ELLIOTT",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "941-444-1730",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2B17-IPI-002",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in McHenry, IL
• Providers in McHenry, IL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.