Abc Developmental Play, LTD

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

License

AV42821006P Issued in IL

Legal business name

ABC DEVELOPMENTAL PLAY, LTD

Practice address

1500 Ravinia PL
1E
Orland Park, IL 60462-3962

Phone

(708) 261-5786

Fax

(708) 478-6773

NPI assigned

Apr 14, 2015

Last updated

Apr 14, 2015By 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

Mrs. Anastasia Maria Vithoulkas, DT,CHILD SP, SP EDNPI 1851516173

Title

President

Phone

(708) 261-5786

Specialties & licenses 1

Addresses

Locations

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.

• Anastasia Maria Vithoulkas, DT

  • Developmental Therapist
  • Orland Park, IL
  • NPI 1851516173
  NPD (past) Authorized official

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

{
    "created_epoch": "1428969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428969600000",
    "number": "1639565864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18236 CLEAR CREEK XING",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604675237",
            "telephone_number": "708-261-5786",
            "fax_number": "708-478-6773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 RAVINIA PL",
            "address_2": "1E",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604623962",
            "telephone_number": "708-261-5786",
            "fax_number": "708-478-6773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABC DEVELOPMENTAL PLAY, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-14",
        "last_updated": "2015-04-14",
        "status": "A",
        "authorized_official_last_name": "VITHOULKAS",
        "authorized_official_first_name": "ANASTASIA",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-261-5786",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DT,CHILD SP, SP ED"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "IL",
            "license": "AV42821006P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Developmental Therapist in Orland Park, IL
• Providers in Orland Park, IL by specialty
• Developmental Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2015; 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.