| NPI | 1992204705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA FALKNER Owner 815-791-6106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: IL LF84050415P) |
| Additional Taxonomies | 222Q00000X Developmental Therapist (Licence: IL LF84050415P) |
| Enumeration Date | 2018-02-07 |
| Last Update Date | 2018-02-07 |