| NPI | 1578794558 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE BUSH Credentialing Manager 847-584-2604 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2009-08-07 |
| Last Update Date | 2022-09-14 |