Organization
PLAY IT FORWARD PEDIATRIC THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA MARION BAKULA (OCCUPATIONAL THERAPIST)
(708) 557-4249
Entity
Organization
Contact information
Practice address
3134 SUNNYSIDE AVE, BROOKFIELD, IL 60513-1328
(630) 240-2135
(630) 563-1696
Mailing address
3134 SUNNYSIDE AVE, BROOKFIELD, IL 60513-1328
(630) 240-2135
(630) 563-1696
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.008322
IL
Other
Enumeration date
10/03/2011
Last updated
01/09/2019
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