NPIMap

Organization Active NPI

Pediasource Therapy Specialists

  • Speech-Language Pathologist
  • Chicago, IL
National Provider Identifier
1891909594
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
PEDIASOURCE THERAPY SPECIALISTS
Practice address
2530 N Lincoln Ave Ste 114
Chicago, IL 60614-2479
Phone
(773) 988-9905
Fax
(773) 404-1774
NPI assigned
May 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Mrs. Hema Raj Trukenbrod, OTRLNPI 1225214224
Title
President
Phone
(773) 988-9905

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Pediatric Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251P0200X
Pediatric Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XP0200X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

2530 N Lincoln Ave Ste 114
Chicago, IL 60614-2479

Mailing address

1872 N Clybourn Ave Apt 111
Chicago, IL 60614-4916
Phone (773) 988-9905

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.

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1891909594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1872 N CLYBOURN AVE APT 111",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606144916",
            "telephone_number": "773-988-9905",
            "fax_number": "773-404-1774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 N LINCOLN AVE STE 114",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606142479",
            "telephone_number": "773-988-9905",
            "fax_number": "773-404-1774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIASOURCE THERAPY SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "TRUKENBROD",
        "authorized_official_first_name": "HEMA",
        "authorized_official_middle_name": "RAJ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-988-9905",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OTRL"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "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 Sep 11, 2025; 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.