| Childhood Potentials Inc. | |
|
101 Old Farm Middle Ct, Bradley, IL 60915-1485 | |
| (815) 932-4812 | |
| (815) 936-9077 |
| Full Name | Childhood Potentials Inc. |
|---|---|
| Type | Facility |
| Speciality | Speech-language Pathologist |
| Location | 101 Old Farm Middle Ct, Bradley, Illinois |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588673602 | NPI | - | NPPES |
| 4632010 | Other | IL | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | (Illinois) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Childhood Potentials Inc. 101 Old Farm Middle Ct, Bradley, IL 60915-1485 Ph: (815) 932-4812 | Childhood Potentials Inc. 101 Old Farm Middle Ct, Bradley, IL 60915-1485 Ph: (815) 932-4812 |
Cynthia Ann Provost, MHS, CCC, SLP/L Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 400 S Kennedy Dr, Suite 600, Bradley, IL 60915 Phone: 815-935-7496 Fax: 815-935-7860 | |
Hallie Marie Outsen, M.A. Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1106 Riverlane Dr, Bradley, IL 60915 Phone: 815-370-3720 | |
Sophia Boyer, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 372 N Grand Ave, Bradley, IL 60915 Phone: 815-603-7856 | |
Robin Cyrier, MHS, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 200 W State St, Bradley, IL 60915 Phone: 815-933-2216 | |
Denise Ann Howard, MHS, CCC-SLP/L Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 101 Old Farm Middle Ct, Bradley, IL 60915 Phone: 815-932-4812 Fax: 815-936-9077 |