| NPI | 1518246255 |
|---|---|
| Doing Business As | BLACK BEAR ACADEMY |
| Entity Type | Organization |
| Authorized Contact | LORI G TALL Executive Director 312-285-2323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| 225XP0200X Occupational Therapist, Pediatrics | |
| 235Z00000X Speech-Language Pathologist, | |
| 252Y00000X Early Intervention Provider Agency (Licence: IL 060006146) | |
| Enumeration Date | 2011-08-11 |
| Last Update Date | 2021-01-11 |