| Pediatric Therapy Of Illinois Llc | |
|
325 N Larch Ave Elmhurst IL 60126-2311 | |
| (630) 415-6850 | |
| (630) 359-4714 |
| Full Name | Pediatric Therapy Of Illinois Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 325 N Larch Ave, Elmhurst, Illinois |
| Authorized Official Name and Position | Diane Dejong (MEMBER) |
| Authorized Official Contact | 6304156850 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Therapy Of Illinois Llc 325 N Larch Ave Elmhurst IL 60126-2311 Ph: (630) 415-6850 | Pediatric Therapy Of Illinois Llc 325 N Larch Ave Elmhurst IL 60126-2311 Ph: (630) 415-6850 |
| NPI Number | 1760863476 |
|---|---|
| Provider Enumeration Date | 06/18/2015 |
| Last Update Date | 06/18/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760863476 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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