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Organization
BRAIN ABC'S
Active
Organization
BRAIN ABC'S
Active
Parent organization
BRAIN ABC'S
Other names
Pamela Cavallo
Organization subpart
Yes
Provider details
NPI number
Legal business name
BRAIN ABC'S
Authorized official
MS. PAMELA A CAVALLO M.ED (OWNER/DEVELOPMENTAL THERAPIST)
(708) 805-0653
Entity
Organization
Contact information
Practice address
213 S PRINCETON AVE, VILLA PARK, IL 60181-2535
(708) 805-0653
Mailing address
213 S PRINCETON AVE, VILLA PARK, IL 60181-2535
(708) 805-0653
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
222Q00000X
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1720290679
DEVELOPMENTAL THERAPIST
IL
01
—
222Q00000X
TAXONOMY
IL
Enumeration date
10/17/2016
Last updated
10/17/2016
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