Kidz Biz Early Intervention

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Legal business name

KIDZ BIZ EARLY INTERVENTION

Practice address

4850 S Lake Park Ave Apt 1708B
Chicago, IL 60615-2073

Phone

(773) 368-8333

Fax

(773) 538-4536

NPI assigned

Mar 24, 2008

Organization subpart

No

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

Authorized official

Name

Ms. Tatia M GoreNPI 1134307804

Title

Speech Pathologist

Phone

(773) 368-8333

Specialties & licenses 1

Addresses

Other names 1

• Tatia Gore Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tatia M Gore

  • Speech-Language Assistant
  • Chicago, IL
  • NPI 1134307804
  NPD (past) Authorized official

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

{
    "created_epoch": "1206316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206316800000",
    "number": "1093987638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 S LAKE PARK AVE APT 1708B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606152073",
            "telephone_number": "773-368-8333",
            "fax_number": "773-538-4536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 S LAKE PARK AVE APT 1708B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606152073",
            "telephone_number": "773-368-8333",
            "fax_number": "773-538-4536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDZ BIZ EARLY INTERVENTION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-24",
        "last_updated": "2008-03-24",
        "status": "A",
        "authorized_official_last_name": "GORE",
        "authorized_official_first_name": "TATIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SPEECH PATHOLOGIST",
        "authorized_official_telephone_number": "773-368-8333",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tatia Gore",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Early Intervention Provider Agency in Chicago, IL
• Providers in Chicago, IL by specialty
• Early Intervention Provider Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; 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.