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NPI Code Detail

MEDICARE: STEPPING STONES PEDIATRIC THERAPY, LLC

MEDICARE: STEPPING STONES PEDIATRIC THERAPY, 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
1261QM1300XMulti-Specialty Clinic/Center146008107IL

General Provider Information

NPI Number : 1851560866
Entity Type Code : Organization
Provider Name (Legal Business Name) : STEPPING STONES PEDIATRIC THERAPY, LLC
Provider Business Mailing Address
First Line : 4866 W BALMORAL AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60630-1504
Country : US
Telephone Number : 312-718-7022
Fax Number :
Provider Business Practice Location Address
First Line : 2645 N SOUTHPORT AVE # 2
Second Line :
City : CHICAGO
State : IL
Zip : 60614-1227
Country : US
Telephone Number : 312-718-7022
Fax Number :
Authorized Official
Title or Position : SPEECH PATHOLOGIST/MANAGER
Name : EMILY DOWELL
Credential : M.S. CCC-SLP
Telephone Number : 312-718-7022
Provider Enumeration Date : 02/22/2008
Last Update Date : 09/25/2008

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Directions to “STEPPING STONES PEDIATRIC THERAPY, LLC ” Practice Location

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