Organization
STARVED ROCK REGIONAL CENTER FOR THERAPY & CHILD DEVELOPMENT
Active
Other names
Easter Seals of LaSalle & Bureau Counties
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAULA SUE WILLIAMSON (PROGRAM DIRECTOR)
(815) 434-0857
Entity
Organization
Contact information
Practice address
1013 ADAMS STREET, OTTAWA, IL 61354-4304
(815) 434-0857
(815) 434-2260
Mailing address
1013 ADAMS STREET, OTTAWA, IL 61354-4304
(815) 434-0857
(815) 434-2260
Taxonomy
Speciality
Code
Description
License number
State
2081P0010X
Pediatric Rehabilitation Medicine Physician
—
IL
225X00000X
Occupational Therapist
—
IL
235Z00000X
Speech-Language Pathologist
—
IL
251V00000X
Voluntary or Charitable Agency
Primary
—
IL
251V00000X
Voluntary or Charitable Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5015093
BCBS
IL
Enumeration date
03/12/2007
Last updated
06/19/2018
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