Organization
PEDIATRIC INTERACTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TRYSTA ANNE LEE (SPEECH LANGUAGE PATHOLOGIST)
(847) 271-6464
Entity
Organization
Contact information
Practice address
15 COMMERCE DR, SUITE 116, GRAYSLAKE, IL 60030-7807
(847) 223-7433
(847) 278-0458
Mailing address
15 COMMERCE DR, SUITE 116, GRAYSLAKE, IL 60030-7807
(847) 223-7433
(847) 278-0458
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
L000-8019-1654
IL
Other
Enumeration date
10/05/2016
Last updated
10/05/2016
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