Fundamentals Pediatric Therapy and Consulting Inc.

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Legal business name

FUNDAMENTALS PEDIATRIC THERAPY AND CONSULTING INC.

Practice address

215 S Springside Dr
Round Lake Beach, IL 60073-8139

Phone

(847) 477-9816

Fax

(847) 574-8147

NPI assigned

Dec 1, 2015

Last updated

Dec 1, 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

Ms. Kirsten Elise Ryan, MA LCPCNPI 1942351184

Title

Therapist

Phone

(847) 477-9816

Specialties & licenses 1

Addresses

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.

• Kirsten Elise Ryan, DT, LCPC

  • Developmental Therapist
  • Round Lake Beach, IL
  • NPI 1942351184
  NPD (past) Authorized official

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

{
    "created_epoch": "1448928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448928000000",
    "number": "1922473008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 S SPRINGSIDE DR",
            "city": "ROUND LAKE BEACH",
            "state": "IL",
            "postal_code": "600738139",
            "telephone_number": "847-477-9816",
            "fax_number": "847-574-8147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 S SPRINGSIDE DR",
            "city": "ROUND LAKE BEACH",
            "state": "IL",
            "postal_code": "600738139",
            "telephone_number": "847-477-9816",
            "fax_number": "847-574-8147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNDAMENTALS PEDIATRIC THERAPY AND CONSULTING INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-01",
        "last_updated": "2015-12-01",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "KIRSTEN",
        "authorized_official_middle_name": "ELISE",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "847-477-9816",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA LCPC"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Medicine Specialists of Round Lake Incorporated S C
• Jennifer Farinosi, RDH
• Nicole C Fishback, RDH
• Gina Fishburn, RDH
• Geminilda Alla Foster, PT
• Laura Galan
• Emily Gierut, L.M.T
• Katherine L Gilman
• Leonard Ginzburg, M.D.
• Rachel Samantha Goldberg, DMD

• Early Intervention Provider Agency in Round Lake Beach, IL
• Providers in Round Lake Beach, IL by specialty
• Early Intervention Provider Agency in Illinois

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