1932585635 NPI number — LOVING STRIDES THERAPY, P.C.

Table of content: (NPI 1932585635)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932585635 NPI number — LOVING STRIDES THERAPY, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LOVING STRIDES THERAPY, P.C.
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:
1932585635
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/24/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7526 FINNIE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEWARK
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60541-9451
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
630-878-8114
Provider Business Mailing Address Fax Number:
630-230-5068

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7526 FINNIE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWARK
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60541-9451
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
630-878-8114
Provider Business Practice Location Address Fax Number:
630-230-5068
Provider Enumeration Date:
08/04/2015

Additional Information

Authorized Official

Authorized Official Last Name:
PAKENHAM
Authorized Official First Name:
MARCIA
Authorized Official Middle Name:
K
Authorized Official Title or Position:
OWNER/PHYSICAL THERAPIST
Authorized Official Telephone Number:
630-878-8114

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251E00000X , with the licence number: 070.010672 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 252Y00000X , with the licence number: 070.010672 , 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: 1194854919 . This is a "PHYSICAL THERAPY" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com