Organization
HEIGHTENED POTENTIAL COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELLEN JEAN BONINE OTR/L, HPCS (DIRECTOR/ THERAPIST)
(630) 408-5845
Entity
Organization
Contact information
Practice address
2956 BASE LINE RD, KIRKLAND, IL 60146-8702
(630) 408-5845
(855) 710-7745
Mailing address
2956 BASE LINE RD, KIRKLAND, IL 60146-8702
(630) 408-5845
(855) 710-7745
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
EM82450304P
IL
Other
Enumeration date
06/19/2015
Last updated
06/19/2015
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