Provider Demographics
NPI:1861207474
Name:SUNNYSIDE THERAPY LLC
Entity type:Organization
Organization Name:SUNNYSIDE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SVETLANA
Authorized Official - Middle Name:
Authorized Official - Last Name:JARDAN
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:224-703-5780
Mailing Address - Street 1:1406 N MITCHELL AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-4652
Mailing Address - Country:US
Mailing Address - Phone:224-703-5780
Mailing Address - Fax:
Practice Address - Street 1:415 W GOLF RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-3929
Practice Address - Country:US
Practice Address - Phone:224-703-5780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty