Organization
M STREET PEDIATRIC THERAPY CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALISON LIDDLE PT, MPP, PCS (OWNER)
(312) 401-0975
Entity
Organization
Contact information
Practice address
719 N MARION ST, OAK PARK, IL 60302-1530
(312) 401-0975
Mailing address
719 N MARION ST, OAK PARK, IL 60302-1530
(312) 401-0975
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
2251P0200X
Pediatric Physical Therapist
Primary
—
IL
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
06/05/2017
Last updated
07/21/2022
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