| NPI | 1477832244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAIL MARIE BURKE Developmental Therapist/Beh Analyst 815-488-0424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: IL GB27580601P) |
| Additional Taxonomies | 251S00000X (Licence: IL 1848614) |
| Enumeration Date | 2011-08-11 |
| Last Update Date | 2011-08-11 |