# PEDIATRIC THERAPY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093011579
- **Authorized official:** MRS. DEBORAH MICHELLE MICHAEL OTR/L (PRESIDENT)
- **Authorized official phone:** (847) 486-4140

## Contact information

- **Practice address:** 1308 WAUKEGAN RD, SUITE 103, GLENVIEW, IL 60025-3070
- **Practice address phone:** (847) 486-4140
- **Practice address fax:** (847) 486-4145
- **Mailing address:** 1308 WAUKEGAN RD, SUITE 103, GLENVIEW, IL 60025-3070
- **Mailing address phone:** (847) 486-4140
- **Mailing address fax:** (847) 486-4145

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD1600X | Developmental Disabilities Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/01/2011
- **Last updated:** 02/01/2011