# ACORN PEDIATRIC THERAPY LLC

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

## Provider details

- **NPI number:** 1700067139
- **Authorized official:** AMI GANDHI OTR/L (OCCUPATIONAL THERAPIST/ MANAGER)
- **Authorized official phone:** (847) 571-4649

## Contact information

- **Practice address:** 824 S MAIN ST, STE 104, CRYSTAL LAKE, IL 60014-6265
- **Practice address phone:** (847) 571-4649
- **Practice address fax:** (815) 788-0087
- **Mailing address:** 824 S MAIN ST, STE 104, CRYSTAL LAKE, IL 60014-6265
- **Mailing address phone:** (847) 571-4649
- **Mailing address fax:** (815) 788-0087

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225X00000X | Occupational Therapist | 056005208 | IL | Yes |
| 235Z00000X | Speech-Language Pathologist | 146000425 | IL | — |

## Other

- **Enumeration date:** 11/14/2007
- **Last updated:** 10/21/2015