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General NPI Number Information
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NPI Number | 1235089756
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Entity Type | Organization
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Legal Business Name | SPECTRUM OF COLORS PEDIATRIC THERAPY LLC
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Dates
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Enumeration Date | 02/03/2026
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 1246 HARVEST LN
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City | UNIVERSITY PARK
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State | IL
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Zip | 60484-3320
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Country | US
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Telephone | 219-999-5515
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Fax |
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Provider Business Mailing Address
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Address Line | 1246 HARVEST LN
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City | UNIVERSITY PARK
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State | IL
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Zip | 60484-3320
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Country | US
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Telephone | 219-999-5515
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KESHEVA POLLARD
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Credential | OTR/L
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Telephone | 219-999-5515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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