=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598077802
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BIG STEPS FOR LITTLE FEET
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/02/2010
-----------------------------------------------------
Last Update Date | 07/02/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6017 W 123RD ST
-----------------------------------------------------
City | PALOS HEIGHTS
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60463-1802
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 708-476-6273
-----------------------------------------------------
Fax | 708-371-6303
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6017 W 123RD ST
-----------------------------------------------------
City | PALOS HEIGHTS
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60463-1802
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 708-476-6273
-----------------------------------------------------
Fax | 708-371-6303
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | MRS. DIANE MARIA LENARD
-----------------------------------------------------
Credential | PT
-----------------------------------------------------
Telephone | 708-476-6273
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 070.005015
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 252Y00000X
-----------------------------------------------------
Taxonomy Name | Early Intervention Provider Agency
-----------------------------------------------------
License Number | 070.005015
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------