Organization
EZEKIEL EARLY CHILDHOOD DEVELOPMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LANETA CHANELLE JOHNSON DT (EARLY INTERVENTION SPECIALIST)
(224) 487-7400
Entity
Organization
Contact information
Practice address
7445 ROOSEVELT RD APT 206-B, FOREST PARK, IL 60130-2555
(224) 487-7400
Mailing address
7445 ROOSEVELT RD APT 206-B, FOREST PARK, IL 60130-2555
(224) 487-7400
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
02/26/2024
Last updated
02/26/2024
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