Organization
EARLY INTERVENTION SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID E ORTIZ (MANAGING PARTNER)
(312) 375-3272
Entity
Organization
Contact information
Practice address
2302 EDGEBROOK DR, ROCKFORD, IL 61107-1411
(815) 226-4978
Mailing address
1015 N HERMITAGE AVE, UNIT B, CHICAGO, IL 60622-3254
(312) 375-3272
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
IL
Other
Enumeration date
07/28/2010
Last updated
07/28/2010
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