NPIMap

Organization Active NPI

Fundamental Therapy

  • Early Intervention Provider Agency
  • Chicago, IL
National Provider Identifier
1447548557
Registry record updated Jul 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
License
070012672 Issued in IL
Legal business name
FUNDAMENTAL THERAPY
Practice address
3721 N Richmond St
Chicago, IL 60618-3524
Phone
(773) 991-9953
Fax
(773) 478-9245
NPI assigned
Jul 11, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2011

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

Authorized official

Name
Kara Boynewicz, PTNPI 1174647069
Title
Owner
Phone
(773) 991-9953

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)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X 070012672 IL Primary

Addresses

Primary practice location

3721 N Richmond St
Chicago, IL 60618-3524

Mailing address

3721 N. Richmond
Chicago, IL 60618
Phone (773) 991-9953

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1310342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310342400000",
    "number": "1447548557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3721 N. RICHMOND",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60618",
            "telephone_number": "773-991-9953",
            "fax_number": "773-478-9245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3721 N RICHMOND ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606183524",
            "telephone_number": "773-991-9953",
            "fax_number": "773-478-9245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNDAMENTAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-11",
        "last_updated": "2011-07-11",
        "status": "A",
        "authorized_official_last_name": "BOYNEWICZ",
        "authorized_official_first_name": "KARA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-991-9953",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "IL",
            "license": "070012672",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 11, 2011; 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.