Organization
ABC DEVELOPMENTAL PLAY, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANASTASIA MARIA VITHOULKAS DT,CHILD SP, SP ED (PRESIDENT)
(708) 261-5786
Entity
Organization
Contact information
Practice address
1500 RAVINIA PL, 1E, ORLAND PARK, IL 60462-3962
(708) 261-5786
(708) 478-6773
Mailing address
18236 CLEAR CREEK XING, ORLAND PARK, IL 60467-5237
(708) 261-5786
(708) 478-6773
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
AV42821006P
IL
Other
Enumeration date
04/14/2015
Last updated
04/14/2015
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