Organization
CLINICAL CONNECTIONS
Active
Other names
Speechkids/OTKids
Organization subpart
No
Provider details
NPI number
Authorized official
CRISLER MAGOR LOVENDAHL (EXECUTIVE DIRECTOR)
(847) 234-0688
Entity
Organization
Contact information
Practice address
2225 LAKESIDE DR, BANNOCKBURN, IL 60015-1265
(847) 234-0688
(847) 234-0687
Mailing address
2225 LAKESIDE DR, BANNOCKBURN, IL 60015-1265
(847) 234-0688
(847) 234-0687
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
54258
IL
225X00000X
Occupational Therapist
056008019
IL
235Z00000X
Speech-Language Pathologist
Primary
146001092
IL
235Z00000X
Speech-Language Pathologist
146008523
IL
235Z00000X
Speech-Language Pathologist
146008990
IL
Other
Enumeration date
04/22/2008
Last updated
04/22/2008
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