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General NPI Number Information
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NPI Number | 1407348220
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Entity Type | Organization
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Legal Business Name | BRIGHT START THERAPY INC.
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Dates
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Enumeration Date | 06/06/2018
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Last Update Date | 06/06/2018
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Provider Practice Location Address
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Address Line | 5116 N NORDICA AVE
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City | CHICAGO
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State | IL
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Zip | 60656-3606
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Country | US
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Telephone | 773-750-3624
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Fax | 708-260-0465
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Provider Business Mailing Address
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Address Line | 5116 N NORDICA AVE
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City | CHICAGO
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State | IL
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Zip | 60656-3606
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Country | US
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Telephone | 773-750-3624
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Fax | 708-260-0465
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Authorized Official
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Title or Position | OWENER
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Name | ERICA ESTRADA
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Credential |
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Telephone | 773-793-4846
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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