Organization
ACORN PEDIATRIC THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMI GANDHI OTR/L (OCCUPATIONAL THERAPIST/ MANAGER)
(847) 571-4649
Entity
Organization
Contact information
Practice address
824 S MAIN ST, STE 104, CRYSTAL LAKE, IL 60014-6265
(847) 571-4649
(815) 788-0087
Mailing address
824 S MAIN ST, STE 104, CRYSTAL LAKE, IL 60014-6265
(847) 571-4649
(815) 788-0087
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056005208
IL
235Z00000X
Speech-Language Pathologist
146000425
IL
Other
Enumeration date
11/14/2007
Last updated
10/21/2015
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