Organization
ASCENDING SPROUTS PEDIATRIC THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTIN WASILEWSKI (SPEECH-LANGUAGE PATHOLOGIST / CEO)
(708) 704-9112
Entity
Organization
Contact information
Practice address
10440 PRINCESS AVE, CHICAGO RIDGE, IL 60415-1805
(708) 704-9112
Mailing address
10440 PRINCESS AVE, CHICAGO RIDGE, IL 60415-1805
(708) 704-9112
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
2355S0801X
Speech-Language Assistant
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
05/03/2021
Last updated
05/03/2021
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