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Organization
AUTISM CLINIC CORP
Active
Organization
AUTISM CLINIC CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONZA SAMAD (RPT)
(708) 745-2884
Entity
Organization
Contact information
Practice address
15349 BLACK FRIARS RD, ORLAND PARK, IL 60462-3877
(708) 745-2884
Mailing address
15349 BLACK FRIARS RD, ORLAND PARK, IL 60462-3877
(708) 745-2884
Taxonomy
Speciality
Code
Description
License number
State
101200000X
Drama Therapist
Primary
—
NULL
101200000X
Drama Therapist
Primary
—
—
Other
Enumeration date
11/20/2025
Last updated
11/20/2025
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