Provider Demographics
NPI:1073709291
Name:LITTLE FEET, BIG STEPS PEDIATRIC THERAPY, INC.
Entity Type:Organization
Organization Name:LITTLE FEET, BIG STEPS PEDIATRIC THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MYSZKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:630-202-5502
Mailing Address - Street 1:15 S GRANT ST
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-1803
Mailing Address - Country:US
Mailing Address - Phone:630-202-5502
Mailing Address - Fax:630-262-8231
Practice Address - Street 1:15 S GRANT ST
Practice Address - Street 2:
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-1803
Practice Address - Country:US
Practice Address - Phone:630-202-5502
Practice Address - Fax:630-202-5502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-20
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056-005762225XP0200X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty
No251E00000XAgenciesHome HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0002233306OtherBCBS