Individual
MS. ERICA ANN VANDERVORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
7222 W CERMAK RD, STE 500, RIVERSIDE, IL 60546-1422
(708) 442-0023
Mailing address
7222 W CERMAK RD, STE 500, RIVERSIDE, IL 60546-1422
(708) 442-0023
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
057.004570
IL
Other
Enumeration date
08/08/2016
Last updated
08/08/2016
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