Organization
PRENDERGAST PEDIATRICS P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHAJA LYNN PRENDERGAST M.S. OTR/L (OWNER)
(810) 656-2863
Entity
Organization
Contact information
Practice address
547 W SURF ST, UNIT 4, CHICAGO, IL 60657-6034
(810) 656-2863
Mailing address
547 W SURF ST, UNIT 4, CHICAGO, IL 60657-6034
(810) 656-2863
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056-008197
IL
Other
Enumeration date
10/09/2012
Last updated
10/09/2012
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