Organization
BRAIN ABC'S
Active
Parent organization
BRAIN ABC'S
Other names
Pamela Cavallo
Organization subpart
Yes
Provider details
NPI number
Legal business name
BRAIN ABC'S
Authorized official
MS. PAMELA A CAVALLO M.ED (OWNER/DEVELOPMENTAL THERAPIST)
(708) 805-0653
Entity
Organization
Contact information
Practice address
213 S PRINCETON AVE, VILLA PARK, IL 60181-2535
(708) 805-0653
Mailing address
213 S PRINCETON AVE, VILLA PARK, IL 60181-2535
(708) 805-0653
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
222Q00000X
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1720290679
DEVELOPMENTAL THERAPIST
IL
01
—
222Q00000X
TAXONOMY
IL
Enumeration date
10/17/2016
Last updated
10/17/2016
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