Organization Active NPI

Liberty Therapy Inc

  • Early Intervention Provider Agency
  • Chicago, IL
National Provider Identifier
1548627045
Registry record updated Jan 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
LIBERTY THERAPY INC
Practice address
5509 N Broadway St
Chicago, IL 60640-1405
Phone
(773) 506-9960
NPI assigned
Jan 28, 2016
Last updated
Jan 28, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2016

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

Authorized official

Name
John Escobar
Title
Vice-President
Phone
(773) 474-6158

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X Primary

Addresses

Primary practice location

5509 N Broadway St
Chicago, IL 60640-1405

Mailing address

PO Box 480134
Niles, IL 60714-0134
Phone (773) 506-9960

National Provider Directory

National Provider Directory

Locations

5509 N Broadway St
Chicago, IL 60640
Phone (773) 506-9960

NPI Registry JSON

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

{
    "created_epoch": "1453939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453939200000",
    "number": "1548627045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 480134",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607140134",
            "telephone_number": "773-506-9960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5509 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401405",
            "telephone_number": "773-506-9960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-28",
        "last_updated": "2016-01-28",
        "status": "A",
        "authorized_official_last_name": "ESCOBAR",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "773-474-6158"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "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 Jan 28, 2016; 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.