Provider Demographics
NPI:1427642446
Name:ACHIEVE PEDIATRIC THERAPY
Entity type:Organization
Organization Name:ACHIEVE PEDIATRIC THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BASIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDFEDER
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:847-868-6531
Mailing Address - Street 1:6137 N BERNARD ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-2211
Mailing Address - Country:US
Mailing Address - Phone:877-522-4438
Mailing Address - Fax:855-673-0845
Practice Address - Street 1:6137 N BERNARD ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-2211
Practice Address - Country:US
Practice Address - Phone:877-522-4438
Practice Address - Fax:855-673-0845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-22
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty