1801975586 NPI number — FOCUSED THERAPIES, LLC

Table of content: (NPI 1801975586)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801975586 NPI number — FOCUSED THERAPIES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FOCUSED THERAPIES, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801975586
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/09/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
96 W MORELAND AVE
Provider Second Line Business Mailing Address:
11 A - C
Provider Business Mailing Address City Name:
ADDISON
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60101-3867
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
630-543-8400
Provider Business Mailing Address Fax Number:
630-543-8400

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
96 W MORELAND AVE
Provider Second Line Business Practice Location Address:
11 A - C
Provider Business Practice Location Address City Name:
ADDISON
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60101-3867
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
630-543-8400
Provider Business Practice Location Address Fax Number:
630-543-8400
Provider Enumeration Date:
11/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SITOWSKI
Authorized Official First Name:
CAROL
Authorized Official Middle Name:
MARY
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
630-543-8400

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  180-005922 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251S00000X , with the licence number: 16650 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X , with the licence number: 72256 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 1635745 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 304341 376533 . This is a "TRI CARE" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 30441341 . This is a "MHN" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 11640159 . This is a "CAQH" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 79177885 . This is a "AETNA" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".




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