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Organization
LEVEL UP PEDIATRIC SPEECH THERAPY, LLC
Active
Organization
LEVEL UP PEDIATRIC SPEECH THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE T DIVALERIO M.A.,CCC-SLP (SPEECH LANGUAGE PATHOLOGIST/OWNER)
(773) 350-9229
Entity
Organization
Contact information
Practice address
289 WAGNER RD, NORTHFIELD, IL 60093-3248
(773) 350-9229
(773) 595-4608
Mailing address
289 WAGNER RD, NORTHFIELD, IL 60093-3248
(773) 350-9229
(773) 595-4608
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146.011212
IL
252Y00000X
Early Intervention Provider Agency
146.011212
IL
Other
Enumeration date
08/20/2014
Last updated
03/22/2018
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