Provider Demographics
NPI:1346088119
Name:INTEGRATED THERAPY NETWORK INC
Entity type:Organization
Organization Name:INTEGRATED THERAPY NETWORK INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR IN OCCUPATIONAL THERAPY
Authorized Official - Prefix:
Authorized Official - First Name:RENATA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUDEK
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L, OTD
Authorized Official - Phone:773-396-3505
Mailing Address - Street 1:5423 S OAK PARK AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60638-2305
Mailing Address - Country:US
Mailing Address - Phone:773-396-3505
Mailing Address - Fax:
Practice Address - Street 1:5423 S OAK PARK AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60638-2305
Practice Address - Country:US
Practice Address - Phone:773-396-3505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty