NPIMap

Organization Active NPI

Luminate Therapy Group of Illinois, LLC

  • Clinical Social Worker
  • Mt. Prospect, IL
National Provider Identifier
1740745934
Registry record updated Feb 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
LUMINATE THERAPY GROUP OF ILLINOIS, LLC
Practice address
580 Slawin Court
Mt. Prospect, IL 60056
Phone
(224) 612-8338
Fax
(512) 894-9901
NPI assigned
Feb 1, 2019
Organization subpart
Yes
Parent organization
LUMINATE THERAPY GROUP OF ILLINOIS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 1, 2019

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

Authorized official

Name
Todd Bock
Title
President
Phone
(512) 858-9900

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

580 Slawin Court
Mt. Prospect, IL 60056

Mailing address

7500 Rialto Boulevard
Building 1 Suite 260
Austin TX, TX 78735
Phone (512) 858-9900

National Provider Directory

National Provider Directory
Part of
Luminate Therapy Group of Illinois LLC

Locations

580 Slawin Ct
Mt Prospect, IL 60056
Phone (224) 612-8338

Practitioners & affiliated clinicians

Practitioners 1

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": "1548979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548979200000",
    "number": "1740745934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 RIALTO BOULEVARD",
            "address_2": "BUILDING 1 SUITE 260",
            "city": "AUSTIN TX",
            "state": "TX",
            "postal_code": "78735",
            "telephone_number": "512-858-9900",
            "fax_number": "512-858-9901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 SLAWIN COURT",
            "city": "MT. PROSPECT",
            "state": "IL",
            "postal_code": "60056",
            "telephone_number": "224-612-8338",
            "fax_number": "512-894-9901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMINATE THERAPY GROUP OF ILLINOIS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LUMINATE THERAPY GROUP OF ILLINOIS, LLC",
        "enumeration_date": "2019-02-01",
        "last_updated": "2019-02-01",
        "status": "A",
        "authorized_official_last_name": "BOCK",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-858-9900"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt. Prospect, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2019; 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.