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Organization

PEDIATRIC POST LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ALLY STEVENS PTA (PTA)
(815) 354-8200
Entity
Organization

Contact information

Practice address
820 E TERRA COTTA AVE # 237-244, CRYSTAL LAKE, IL 60014-3649
(847) 338-4463
(224) 678-0036
Mailing address
820 E TERRA COTTA AVE # 237-244, CRYSTAL LAKE, IL 60014-3649
(815) 354-8200

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
104100000X
Social Worker
224Z00000X
Occupational Therapy Assistant
2251P0200X
Pediatric Physical Therapist
Primary
225200000X
Physical Therapy Assistant
225XP0200X
Pediatric Occupational Therapist
235Z00000X
Speech-Language Pathologist

Other

Enumeration date
09/20/2022
Last updated
03/09/2023
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