Healthcare Provider Details

I. General information

NPI: 1235089756
Provider Name (Legal Business Name): SPECTRUM OF COLORS PEDIATRIC THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2026
Last Update Date: 03/14/2026
Certification Date: 03/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

597 W EXCHANGE ST
CRETE IL
60417-2004
US

IV. Provider business mailing address

1246 HARVEST LN
UNIVERSITY PARK IL
60484-3320
US

V. Phone/Fax

Practice location:
  • Phone: 708-439-6830
  • Fax:
Mailing address:
  • Phone: 708-439-6830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: KESHEVA POLLARD
Title or Position: OWNER
Credential: OTR/L
Phone: 708-439-6830