Organization
THE CHAMPION CENTER FOR AUTISM, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATRICE A HARRELL (EXECUTIVE DIRECTOR)
(708) 213-7991
Entity
Organization
Contact information
Practice address
17500 SYCAMORE AVE, COUNTRY CLUB HILLS, IL 60478-4884
(708) 213-7991
(708) 365-6765
Mailing address
17500 SYCAMORE AVE, COUNTRY CLUB HILLS, IL 60478-4884
(708) 213-7991
(708) 365-6765
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
IL
103TB0200X
Cognitive & Behavioral Psychologist
—
IL
103TC2200X
Clinical Child & Adolescent Psychologist
—
IL
174H00000X
Health Educator
—
IL
222Q00000X
Developmental Therapist
—
IL
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
IL
225XF0002X
Feeding, Eating & Swallowing Occupational Therapist
—
IL
225XR0403X
Driving and Community Mobility Occupational Therapist
—
IL
235Z00000X
Speech-Language Pathologist
—
IL
Other
Enumeration date
01/20/2015
Last updated
01/20/2015
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