Provider Demographics
NPI:1104047158
Name:PEDIATRIC THERAPY CONNECTIONS, INC
Entity type:Organization
Organization Name:PEDIATRIC THERAPY CONNECTIONS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:E
Authorized Official - Last Name:WEROSH
Authorized Official - Suffix:
Authorized Official - Credentials:MHS
Authorized Official - Phone:773-610-4664
Mailing Address - Street 1:9748 S HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-1644
Mailing Address - Country:US
Mailing Address - Phone:773-610-4664
Mailing Address - Fax:773-881-0660
Practice Address - Street 1:9748 S HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-1644
Practice Address - Country:US
Practice Address - Phone:773-610-4664
Practice Address - Fax:773-881-0660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health