NPIMap

Organization Active NPI

Lakeside Therapy

  • Developmental Therapist
  • Barrington, IL
National Provider Identifier
1669093878
Registry record updated Apr 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
Legal business name
LAKESIDE THERAPY
Practice address
69 Lake Shore Dr
Barrington, IL 60010-1414
Phone
(847) 650-1796
NPI assigned
Apr 28, 2020
Last updated
Apr 28, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2020

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

Authorized official

Name
Audrey AbborenoNPI 1487285128
Title
Owner
Phone
(847) 650-1796

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
Developmental Therapist 222Q00000X NU Primary

Addresses

Primary practice location

69 Lake Shore Dr
Barrington, IL 60010-1414

Mailing address

69 Lake Shore Dr
Barrington, IL 60010-1414
Phone (847) 650-1796

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1588032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588032000000",
    "number": "1669093878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 LAKE SHORE DR",
            "city": "BARRINGTON",
            "state": "IL",
            "postal_code": "600101414",
            "telephone_number": "847-650-1796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 LAKE SHORE DR",
            "city": "BARRINGTON",
            "state": "IL",
            "postal_code": "600101414",
            "telephone_number": "847-650-1796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-28",
        "last_updated": "2020-04-28",
        "certification_date": "2020-04-28",
        "status": "A",
        "authorized_official_last_name": "ABBORENO",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-650-1796"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Barrington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.