| NPI | 1528467370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE FOWLER Manager 847-254-1040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: IL 146007078) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: IL 056010239) |
| 235Z00000X Speech-Language Pathologist, (Licence: IL 1460099190) | |
| Enumeration Date | 2014-08-18 |
| Last Update Date | 2015-01-05 |