1437676400 NPI number — CONNIE CARES FOR KIDS-ADHD AND LEARNING DISABILITIES, LLC

Table of content: (NPI 1437676400)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437676400 NPI number — CONNIE CARES FOR KIDS-ADHD AND LEARNING DISABILITIES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CONNIE CARES FOR KIDS-ADHD AND LEARNING DISABILITIES, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
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Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
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Provider Other Last Name:
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NPI Number Information

NPI Number:
1437676400
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/21/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3268 MILLRACE LANE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MONTGOMERY
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60538
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
630-363-9368
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4580 WEAVER PKWY STE 102
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WARRENVILLE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60555-3864
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
630-473-3970
Provider Business Practice Location Address Fax Number:
630-994-5028
Provider Enumeration Date:
08/29/2017

Additional Information

Authorized Official

Authorized Official Last Name:
PARR
Authorized Official First Name:
CONNIE
Authorized Official Middle Name:
LEE
Authorized Official Title or Position:
NURSE PRACTITIONER, OWNER
Authorized Official Telephone Number:
630-363-9368

Provider Taxonomy Codes

  • Taxonomy code: 363LP0808X , with the licence number:  209000942 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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