| NPI | 1982327458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLY STEVENS PT A 815-354-8200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics |
| Additional Taxonomies | 104100000X Social Worker |
| 224Z00000X Occupational Therapy Assistant | |
| 225200000X Physical Therapy Assistant | |
| 225XP0200X Occupational Therapist, Pediatrics | |
| 235Z00000X Speech-Language Pathologist, | |
| 101Y00000X Counselor | |
| Enumeration Date | 2022-09-20 |
| Last Update Date | 2023-03-09 |