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Organization

EZEKIEL EARLY INTERVENTION SERVICES L.L.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LANETA CHANELLE JOHNSON DT (DEVELOPMENTAL THERAPIST)
(773) 850-5543
Entity
Organization

Contact information

Practice address
7445 ROOSEVELT RD APT 7445, FOREST PARK, IL 60130-2555
(773) 850-5543
(773) 850-5543
Mailing address
7445 ROOSEVELT RD APT 206-B, 7445, FOREST PARK, IL 60130-2555
(773) 850-5543
(773) 850-5543

Taxonomy

Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary

Other

Enumeration date
01/15/2026
Last updated
01/15/2026
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