Whalio Doctors

NPI 1013316470

Family Building Blocks

Organisation Early Intervention Provider Agency Chicago, IL

Practice location

Address
10450 S Western Ave, Chicago, IL 60643-2508
Phone
(773) 429-9454

Authorised official

Name
Tracy Bouck
Title
Lcpc
Phone
(773) 429-9454

Registered specialties

Early Intervention Provider Agency Primary
Agencies Taxonomy 252Y00000X Licence 1825273 (IL)

Registry record

NPI
1013316470
Entity type
Organization
NPI issued
21 Aug 2014
Record last updated
21 Aug 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.