Organization
NORTHWEST PEDIATRIC THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. THERESA ANNE BARNES OTRL (PRESIDENT CEO DIRECTOR)
(847) 462-9750
Entity
Organization
Contact information
Practice address
1005 ALEXANDER CT, UNIT A, CARY, IL 60013-1891
(847) 462-9750
(847) 462-9751
Mailing address
1005 ALEXANDER CT, UNIT A, CARY, IL 60013-1891
(847) 462-9750
(847) 462-9751
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05632149
BCBS
—
Enumeration date
12/28/2006
Last updated
08/31/2010
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