Organization
AUTISM SUPPORT CHICAGO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE LUCKEY (CREDENTIALING/BILLING MANAGER)
(765) 860-7198
Entity
Organization
Contact information
Practice address
401 BURKE DR, JOLIET, IL 60433-2113
(815) 630-6408
(815) 770-7433
Mailing address
3003 GARI BALDI WAY, SPRING HILL, TN 37174-6282
(815) 630-6408
(815) 770-7433
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
05/04/2020
Last updated
05/06/2020
About Stedi
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