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Organization

INNOVATIVE PEDIATRIC THERAPY, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TODD M BRUECK (OFFICE MANAGER)
(773) 332-0403
Entity
Organization

Contact information

Practice address
1908 N MOHAWK ST, UNIT 22, CHICAGO, IL 60614-5220
(773) 677-3758
(312) 787-3072
Mailing address
1908 N MOHAWK ST, UNIT 22, CHICAGO, IL 60614-5220
(773) 677-3758
(312) 787-3072

Taxonomy

Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
070.013401
IL

Other

Enumeration date
04/24/2009
Last updated
04/24/2009
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