| NPI | 1114649399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADI O'ROURKE Speech Language Pathologist 815-212-7162 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2022-09-14 |
| Last Update Date | 2022-09-14 |