Active NPI
Play Date Therapy
- Early Intervention Provider Agency
- Chicago, IL
National Provider Identifier
1124669973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Early Intervention Provider Agency
- Legal business name
- PLAY DATE THERAPY
- Practice address
- 5624 S Meade Ave
Chicago, IL 60638-3504 - Phone
- (708) 259-3171
- NPI assigned
- Oct 2, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Nicole Brennan
- Title
- President
- Phone
- (708) 259-3171
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Early Intervention Provider Agency | 252Y00000X | Primary |
Addresses
Primary practice location
5624 S Meade Ave
Chicago, IL 60638-3504
Mailing address
5624 S Meade Ave
Chicago, IL 60638-3504
Phone (708) 259-3171
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326464546 | Other | DEVELOPMENTAL THERAPIST |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Developmental Therapist
- Chicago, IL
- NPI 1326464546
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569974400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1569974400000",
"number": "1124669973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5624 S MEADE AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606383504",
"telephone_number": "708-259-3171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5624 S MEADE AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606383504",
"telephone_number": "708-259-3171"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PLAY DATE THERAPY",
"organizational_subpart": "NO",
"enumeration_date": "2019-10-02",
"last_updated": "2019-10-02",
"status": "A",
"authorized_official_last_name": "BRENNAN",
"authorized_official_first_name": "NICOLE",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "708-259-3171"
},
"taxonomies": [
{
"code": "252Y00000X",
"taxonomy_group": "",
"desc": "Early Intervention Provider Agency",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEVELOPMENTAL THERAPIST",
"identifier": "1326464546",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.