Organization
OT MAGIC INC.
Active
Organization
OT MAGIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VALERIE MAXWELL-SOFIYEA O.T.R. (PRESIDENT)
(773) 510-7431
Entity
Organization
Contact information
Practice address
1666 W 103RD ST, CHICAGO, IL 60643-2819
(773) 510-7431
(773) 233-0756
Mailing address
1666 W 103RD ST, CHICAGO, IL 60643-2819
(773) 510-7431
(773) 233-0756
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
VM736105001
IL
Other
Enumeration date
05/17/2010
Last updated
05/17/2010
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