Organization
BRAVO PEDIATRIC THERAPIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLAUDETTE L SANCHEZ SLP (PRESIDENT/SPEECH LANGUAGE PATHOLOGI)
(773) 551-0004
Entity
Organization
Contact information
Practice address
1153 GUNDERSON AVE, OAK PARK, IL 60304-2150
(773) 551-0004
(733) 305-8081
Mailing address
1153 GUNDERSON AVE, OAK PARK, IL 60304-2150
(773) 551-0004
(773) 305-8081
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146006271
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01636006
BLUE CROSS BLUE SHIELD
IL
Enumeration date
11/16/2006
Last updated
12/21/2024
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