Central Illinois Developmental Therapy, Inc.

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

Legal business name

CENTRAL ILLINOIS DEVELOPMENTAL THERAPY, INC.

Practice address

762 8TH St
Charleston, IL 61920-2116

Phone

(217) 821-1752

Fax

(217) 345-0910

NPI assigned

May 14, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Vivian Faye Winchester

Title

President

Phone

(217) 821-1752

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Cheryl Penman, CDS

  • Developmental Therapist
  • Sherman, IL
  • NPI 1588879423
  NPD (past)

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1578778403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1702",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619381702",
            "telephone_number": "217-821-1752",
            "fax_number": "217-345-0910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "762 8TH ST",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "619202116",
            "telephone_number": "217-821-1752",
            "fax_number": "217-345-0910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL ILLINOIS DEVELOPMENTAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WINCHESTER",
        "authorized_official_first_name": "VIVIAN",
        "authorized_official_middle_name": "FAYE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-821-1752"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "336564313001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Central East Alcoholism and Drug Council
• Central East Alcoholism and Drug Council
• Central East Alcoholism and Drug Council
• Central East Alcoholism and Drug Council
• Central Illinois Autism Therapeutic Services, NFP
• Central Illinois Vision Associates LTD
• Charleston Chiropractic Center LLC
• Charleston Community Unit School District #1
• Charleston Estates, LLC
• Charleston Hco LLC (Charleston Rehab & Health Care Center)

• Developmental Therapist in Charleston, IL
• Providers in Charleston, IL by specialty
• Developmental Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.