Organization
KREIDER SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TRINA R OBRIEN (COMMUNITY SERVICES MANAGER)
(815) 288-6691
Entity
Organization
Contact information
Practice address
500 ANCHOR ROAD, DIXON, IL 61021-8829
(815) 288-6691
(815) 288-1636
Mailing address
500 ANCHOR ROAD, DIXON, IL 61021-8829
(815) 288-6691
(815) 288-1636
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
071007493
IL
222Q00000X
Developmental Therapist
—
IL
225100000X
Physical Therapist
070002814
IL
225X00000X
Occupational Therapist
056005546
IL
225X00000X
Occupational Therapist
056006700
IL
235Z00000X
Speech-Language Pathologist
14600657
IL
235Z00000X
Speech-Language Pathologist
146008250
IL
251B00000X
Case Management Agency
—
IL
251C00000X
Developmentally Disabled Services Day Training Agency
—
IL
252Y00000X
Early Intervention Provider Agency
Primary
—
IL
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
IL
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
12/26/2006
Last updated
08/22/2016
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