Decoach, Inc

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Legal business name

DECOACH, INC

Practice address

3320 Lincoln St
Franklin Park, IL 60131-1514

Phone

(630) 999-6619

NPI assigned

Aug 13, 2014

Last updated

Sep 8, 2014By 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. Patrycja Sudol

Title

Founder and Chief Executive Officer

Phone

(773) 905-7135

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1407888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410134400000",
    "number": "1932518131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3320 LINCOLN ST",
            "city": "FRANKLIN PARK",
            "state": "IL",
            "postal_code": "601311514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 LINCOLN ST",
            "city": "FRANKLIN PARK",
            "state": "IL",
            "postal_code": "601311514",
            "telephone_number": "630-999-6619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECOACH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-13",
        "last_updated": "2014-09-08",
        "status": "A",
        "authorized_official_last_name": "SUDOL",
        "authorized_official_first_name": "PATRYCJA",
        "authorized_official_title_or_position": "FOUNDER AND CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "773-905-7135",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zena Darhoom
• Paul Eugene Davis Jr., M.D.
• Anthony J De Monte, LCPC
• Rafal Debski
• Jean Marie Decaro
• Winona Desarmes
• Laura Stefany Diaz, LCSW
• Sarah Jean Dimitrov, MSW
• Christopher Thomas Dimos, RPH
• Amanda M Donis

• Early Intervention Provider Agency in Franklin Park, IL
• Providers in Franklin Park, 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 Sep 8, 2014; 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.