Organization
PROVISO AREA EXCEPTIONAL CHILD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUE CALLAHAN (EXECUTIVE SECRETARY)
(708) 450-2157
Entity
Organization
Contact information
Practice address
1000 VAN BUREN ST, MAYWOOD, IL 60153-1970
(708) 450-2157
Mailing address
1000 VAN BUREN ST, MAYWOOD, IL 60153-1970
(708) 450-2157
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Enumeration date
06/17/2015
Last updated
03/15/2016
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