| NPI | 1952776593 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE MARIE LUCAS Owner 708-670-5659 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: IL 060011474) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| 251E00000X Home Health | |
| 261QP2000X Clinic/Center, Physical Therapy | |
| 261QX0100X Clinic/Center, Occupational Medicine | |
| Enumeration Date | 2015-12-08 |
| Last Update Date | 2021-03-16 |