MEDICARE: BIG WONDERS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	171R00000X	Interpreter
2	222Q00000X	Developmental Therapist
3	252Y00000X	Early Intervention Provider Agency

General Provider Information

NPI Number	:	1649039249
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BIG WONDERS INC

Provider Business Mailing Address
First Line	:	5226 W DEMING PL
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60639-4395
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5226 W DEMING PL
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60639-4395
Country	:	US
Telephone Number	:	773-766-7616
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	ANNA LANDAVERRY
Credential	:
Telephone Number	:	773-724-1363

Provider Enumeration Date	:	03/15/2024
Last Update Date	:	03/15/2024

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Directions to “BIG WONDERS INC ” Practice Location

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