Organization
FUN MOVES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FRANK LUCAS (DIRECTOR)
(847) 873-5779
Entity
Organization
Contact information
Practice address
2500 W BRADLEY PL, CHICAGO, IL 60618-4702
(773) 991-7316
(773) 572-4886
Mailing address
3344 BELLWOOD LN, GLENVIEW, IL 60026-1528
(773) 991-7316
(773) 572-4886
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
056001897
IL
Other
Enumeration date
02/18/2016
Last updated
02/18/2016
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