OVER THE MOON PEDIATRIC THERAPY CO
Agencies at Ivywild Ln, Mokena, IL

License number
Illinois MV60460511P
Category
Agencies
Type
Early Intervention Provider Agency
Owner
Name: MRS. MICHELE VALECEK
Title: OWNER
Phone: (815) 212-0536
Address
Address
3308 Ivywild Ln, Mokena, IL 60451
National Provider ID: 1710308580
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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OVER THE MOON PEDIATRIC THERAPY COMPANY

Mokena, IL

Industry:
Specialty Outpatient Clinic
Registration:
Jan 30, 2014
Addresses:
New Lenox, IL 60451 (Physical)
3308 Ivywild Ln, Mokena, IL 60451
State ID:
69219578
Business type:
Domestic Bca
Expiration:
Perpetual
Agent:
Michele M Valecek,3308 Ivywild Ln, New Lenox, IL 60451 (Physical)

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