Organization
PEDIATRIC REHABILITATION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELIZABETH JOHNSON MARUVAMA OTRL (PARTNER)
(630) 964-4707
Entity
Organization
Contact information
Practice address
5201 WALNUT AVENUE, STE 4, DOWNERS GROVE, IL 60515-4025
(630) 964-4707
(630) 964-4797
Mailing address
5201 WALNUT AVENUE, STE 4, DOWNERS GROVE, IL 60515-4025
(630) 964-4707
(630) 964-4797
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
01/18/2007
Last updated
08/22/2020
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