Individual
MORGAN ANN BANASIAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.ED.
Contact information
Practice address
630 FIELDCREST DR, WEST CHICAGO, IL 60185-5158
(630) 816-7034
(630) 562-2550
Mailing address
630 FIELDCREST DR, WEST CHICAGO, IL 60185-5158
(630) 816-7034
(630) 562-2550
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MB79950898P
E.I. CREDENTIAL
IL
Enumeration date
04/02/2007
Last updated
07/08/2007
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