Organization
DISTINCTIVE DEVELOPMENTAL THERAPY SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARIO AGUILAR DT DEVELOPMENTAL THE (PRESIDENT)
(773) 505-2357
Entity
Organization
Contact information
Practice address
1842 S HOME AVE, #2, BERWYN, IL 60402-1618
(773) 505-2357
(708) 788-0967
Mailing address
1842 S HOME AVE, #2, BERWYN, IL 60402-1618
(773) 505-2357
(708) 788-0967
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
MA42490698P
IL
Other
Enumeration date
03/09/2007
Last updated
08/22/2020
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