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Organization
DISTINCTIVE DEVELOPMENTAL THERAPY SERVICES INC
Active
Organization
DISTINCTIVE DEVELOPMENTAL THERAPY SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARIO AGUILAR DT DEVELOPMENTAL THE (PRESIDENT)
(773) 505-2357
Entity
Organization
Contact information
Practice address
1842 S HOME AVE, #2, BERWYN, IL 60402-1618
(773) 505-2357
(708) 788-0967
Mailing address
1842 S HOME AVE, #2, BERWYN, IL 60402-1618
(773) 505-2357
(708) 788-0967
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
MA42490698P
IL
Other
Enumeration date
03/09/2007
Last updated
08/22/2020
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