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General NPI Number Information
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NPI Number | 1851560866
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Entity Type | Organization
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Legal Business Name | STEPPING STONES PEDIATRIC THERAPY, LLC
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Dates
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Enumeration Date | 02/22/2008
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Last Update Date | 09/25/2008
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Provider Practice Location Address
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Address Line | 2645 N SOUTHPORT AVE # 2
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City | CHICAGO
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State | IL
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Zip | 60614-1227
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Country | US
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Telephone | 312-718-7022
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Fax |
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Provider Business Mailing Address
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Address Line | 4866 W BALMORAL AVE
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City | CHICAGO
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State | IL
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Zip | 60630-1504
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Country | US
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Telephone | 312-718-7022
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Fax |
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Authorized Official
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Title or Position | SPEECH PATHOLOGIST/MANAGER
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Name | EMILY DOWELL
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Credential | M.S. CCC-SLP
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Telephone | 312-718-7022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | 146008107
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License Number State | IL
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