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Organization

PEDIAPROGRESS, INC.

Active
Other names
Pediaprogress
Organization subpart
No

Provider details

NPI number
Authorized official
MALINDA VASILAKOPOULOS MA (PRESIDENT)
(630) 929-0122
Entity
Organization

Contact information

Practice address
1101 31ST ST STE 110, DOWNERS GROVE, IL 60515-5562
(630) 929-0122
(630) 729-0134
Mailing address
1101 31ST ST STE 110, DOWNERS GROVE, IL 60515-5562
(630) 929-0122
(630) 729-0134

Taxonomy

Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
2251P0200X
Pediatric Physical Therapist
225XP0200X
Pediatric Occupational Therapist
235Z00000X
Speech-Language Pathologist
252Y00000X
Early Intervention Provider Agency
261QM1300X
Multi-Specialty Clinic/Center
Primary

Other

Enumeration date
09/11/2008
Last updated
09/16/2020
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