M STREET PEDIATRIC THERAPY CORP (NPI# 1588193593) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588193593 |
| Entity Type | Organization |
| Organization Name | M STREET PEDIATRIC THERAPY CORP |
| Practice Address |
719 N Marion St Oak Park IL 60302-1530 |
| Practice Telephone | (312) 401-0975 |
| Mailing Telephone | 3124010975 |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2018-11-26 |
| Authorized Official Name | ALISON LIDDLE (OWNER) |
| Authorized Official Telephone | 3124010975 |
| Authorized Official Credential | PT, MPP, PCS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225XP0200X |
Occupational Therapist Specialization: Pediatrics |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers | ||
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| Y | 2251P0200X |
Physical Therapist Specialization: Pediatrics |
IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
719 N MARION ST |
| City | OAK PARK |
| State | IL |
| Zip Code | 60302-1530 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164033494 | Stephanie Elizabeth Richardson | Physical Therapist | 719 N Marion St, Oak Park, IL 60302-1530 | 2020-08-11 |
| 1457979023 | Allison Hutchinson | Speech-Language Pathologist | 719 N Marion St, Oak Park, IL 60302-1530 | 2020-07-10 |
| 1598390809 | Briana Jo Moorman | Physical Therapist | 719 N Marion St, Oak Park, IL 60302-1530 | 2020-03-06 |
| 1639717184 | Christina Quan | Clinic/Center | 719 N Marion St, Oak Park, IL 60302-1530 | 2019-12-16 |
| 1669017752 | Katelyn Ann Kruszynski | Occupational Therapist | 719 N Marion St, Oak Park, IL 60302-1530 | 2019-11-12 |
| 1164066940 | Julie Marie Kappas | Occupational Therapist | 719 N Marion St, Oak Park, IL 60302-1530 | 2019-11-04 |
| 1427607860 | Emily Shannon Murray | Occupational Therapist | 719 N Marion St, Oak Park, IL 60302-1530 | 2019-09-09 |
| 1245884576 | Ashley Renee Smith | Physical Therapist | 719 N Marion St, Oak Park, IL 60302-1530 | 2019-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306473244 | Tasha Kimberly Young | Counselor | 1216 N Austin Bvld, Oak Park, IL 60302 | 2020-03-23 |
| 1306492186 | Camiesa Rashida Rogers | Pharmacy Technician | 626 N Austin #7, Oak Park, IL 60302 | 2019-08-16 |
| 1326603887 | Right Choice Therapy LLC | Social Worker | 428 S. Scoville Avenue, Rear 1b, Oak Park, IL 60302 | 2019-05-09 |
| 1407328941 | Arundathi Bannur Suresh | Occupational Therapist | 3 Erie Court, West Suburban Medical Center, Oak Park, IL 60302 | 2018-12-21 |
| 1427537455 | Shannon Vogel | Occupational Therapist | 405 Home Ave Apt 207, Oak Park, IL 60302 | 2018-08-10 |
| 1568958726 | Loretto Hospital | Clinic/Center | 1000 Madison St, Oak Park, IL 60302 | 2018-07-10 |
| 1649783143 | Mary Joyce Arenas Lagatao | Nurse Practitioner | 101 Madison St, 3rd Floor, Oak Park, IL 60302 | 2017-11-07 |
| 1427578251 | Amanda Lam | Behavior Technician | 721 South Blvd., Suite 210, Oak Park, IL 60302 | 2017-06-22 |
| 1649790577 | Samantha Lotti | Acupuncturist | 1119 Pleasant St, Oak Park, IL 60302 | 2017-06-21 |
| 1770010480 | Robert Smith IIi | Behavior Technician | 412a S. Taylor Ave, Oak Park, IL 60302 | 2017-05-12 |
| Find all providers in zip 60302 | ||||
| Taxonomy Code | 2251P0200X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912245739 | Laura Zawacki | Physical Therapist | 923 N Elmwood Ave, Oak Park, IL 60302-1352 | 2013-01-29 |
| 1174754766 | Adriana Silva | Physical Therapist | 603 Washington Blvd Apt 1, Oak Park, IL 60302-3980 | 2009-07-31 |
| 1770615320 | Catherine Marie Morgan | Physical Therapist | 1027 N Kenilworth Ave, Oak Park, IL 60302-1317 | 2007-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841750411 | Crawl Walk Leap P.C. | Physical Therapist | 720 W Randolph St Apt 1103, Chicago, IL 60661-2171 | 2019-03-21 |
| 1912478777 | Elaine Rodriguez | Physical Therapist | 3332 N Kostner Ave, Chicago, IL 60641-4513 | 2018-12-05 |
| 1437625001 | Jennifer K. Buccelli, Mpt | Physical Therapist | 597 Plymouth Ct, Gurnee, IL 60031-3229 | 2018-10-22 |
| 1124511159 | Molly Victorine | Physical Therapist | 1375 Newcastle Ln, Hoffman Estates, IL 60169-1225 | 2018-06-13 |
| 1750896163 | Julie Ann Brady | Physical Therapist | 430 Nevada St, Frankfort, IL 60423-1565 | 2017-12-07 |
| 1467965939 | Carla Gain | Physical Therapist | 118 Westhaven School Rd, Belleville, IL 62220-3264 | 2017-11-07 |
| 1538678354 | Anita Tallegien Daneshdoost | Physical Therapist | 1725 Shomaker Drive, Murphysboro, IL 62966 | 2017-09-25 |
| 1861917189 | Marisa Raineri | Physical Therapist | 750 Pasquinelli Dr., #204, Westmont, IL 60559 | 2017-08-08 |
| 1669915674 | Anna's Pediatric Physical Therapy LLC | Physical Therapist | 2120 W Armitage Ave, Unit 1, Chicago, IL 60647-4516 | 2016-11-22 |
| 1417409970 | Katherine Wolff | Physical Therapist | 12 N Kenilworth Ave, Mount Prospect, IL 60056-2232 | 2016-11-01 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.