HEIGHTENED POTENTIAL COMPANY
Agencies at Base Line Rd, Fairdale, IL

License number
Illinois EM82450304P
Category
Agencies
Type
Early Intervention Provider Agency
Owner
Name: MRS. ELLEN JEAN BONINE OTR/L, HPCS
Title: DIRECTOR/ THERAPIST
Phone: (630) 408-5845
Address
Address
2956 Base Line Rd, Fairdale, IL 60146
National Provider ID: 1992187504
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.