# PLAY IT FORWARD PEDIATRIC THERAPY, LLC

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

## Provider details

- **NPI number:** 1255615738
- **Authorized official:** THERESA MARION BAKULA (OCCUPATIONAL THERAPIST)
- **Authorized official phone:** (708) 557-4249

## Contact information

- **Practice address:** 3134 SUNNYSIDE AVE, BROOKFIELD, IL 60513-1328
- **Practice address phone:** (630) 240-2135
- **Practice address fax:** (630) 563-1696
- **Mailing address:** 3134 SUNNYSIDE AVE, BROOKFIELD, IL 60513-1328
- **Mailing address phone:** (630) 240-2135
- **Mailing address fax:** (630) 563-1696

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225X00000X | Occupational Therapist | 056.008322 | IL | Yes |

## Other

- **Enumeration date:** 10/03/2011
- **Last updated:** 01/09/2019