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NPI Code Detail

MEDICARE: EARLY AUTISM SERVICES, LLC

MEDICARE: EARLY AUTISM SERVICES, LLC
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist
2235Z00000XSpeech-Language Pathologist
3103K00000XBehavior Analyst

General Provider Information

NPI Number : 1700130713
Entity Type Code : Organization
Provider Name (Legal Business Name) : EARLY AUTISM SERVICES, LLC
Provider Business Mailing Address
First Line : 1721 MOON LAKE BLVD STE 140
Second Line :
City : HOFFMAN ESTATES
State : IL
Zip : 60169-1070
Country : US
Telephone Number : 312-965-2997
Fax Number : 312-929-0324
Provider Business Practice Location Address
First Line : 5705 WILLOW SPRINGS RD
Second Line :
City : COUNTRYSIDE
State : IL
Zip : 60525-3478
Country : US
Telephone Number : 312-914-0611
Fax Number : 312-929-0324
Authorized Official
Title or Position : OWNER
Name : BENJAMIN WESSELS
Credential :
Telephone Number : 312-965-2997
Provider Enumeration Date : 10/30/2012
Last Update Date : 04/23/2025

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Directions to “EARLY AUTISM SERVICES, LLC ” Practice Location

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