Provider Demographics
NPI:1336335660
Name:TODDLERS N' TYKES THERAPY INC.
Entity type:Organization
Organization Name:TODDLERS N' TYKES THERAPY INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDER-JENDERSAK
Authorized Official - Suffix:
Authorized Official - Credentials:MOT OTR/L
Authorized Official - Phone:630-673-6050
Mailing Address - Street 1:19227 JUNIPER LN
Mailing Address - Street 2:
Mailing Address - City:MOKENA
Mailing Address - State:IL
Mailing Address - Zip Code:60448-8132
Mailing Address - Country:US
Mailing Address - Phone:630-373-6050
Mailing Address - Fax:708-478-5291
Practice Address - Street 1:19227 JUNIPER LN
Practice Address - Street 2:
Practice Address - City:MOKENA
Practice Address - State:IL
Practice Address - Zip Code:60448-8132
Practice Address - Country:US
Practice Address - Phone:630-373-6050
Practice Address - Fax:708-478-5291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-20
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1235277393OtherEARLY INTERVENTION
IL1316068661OtherEARLY INTERVENTION