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General NPI Number Information
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NPI Number | 1649039249
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Entity Type | Organization
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Legal Business Name | BIG WONDERS INC
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Dates
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Enumeration Date | 03/15/2024
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Last Update Date | 03/15/2024
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Provider Practice Location Address
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Address Line | 5226 W DEMING PL
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City | CHICAGO
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State | IL
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Zip | 60639-4395
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Country | US
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Telephone | 773-766-7616
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Fax |
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Provider Business Mailing Address
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Address Line | 5226 W DEMING PL
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City | CHICAGO
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State | IL
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Zip | 60639-4395
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | ANNA LANDAVERRY
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Credential |
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Telephone | 773-724-1363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171R00000X
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Taxonomy Name | Interpreter
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State |
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Taxonomy #3
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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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