Independent Provider
Independent Provider is an Early Intervention Provider Agency in Chicago, Illinois. Licensed in Illinois. Registered with an NPI since 2016.
- Licensed in
- IL
- In the registry since
- 2016
Practice location Address checks out
3800 W 106th StChicago, IL 60655-3815
Phone: (773) 759-2403
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Early Intervention Provider Agency (primary) | Taxonomy 252Y00000X · Licence 242003723 (IL) |
|---|
Record details
| NPI number | 1558718023 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Kathleen Moloney — Speech-Language Pathologist · (773) 759-2403 |
| NPI enumerated | May 15, 2016 |
| Last updated in NPPES | May 15, 2016 |
| Mailing address | 3800 W 106th St, Chicago, IL 60655-3815 |
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