Provider Demographics
NPI:1083138358
Name:EARLY DYNAMICS
Entity Type:Organization
Organization Name:EARLY DYNAMICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HILDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTRADA
Authorized Official - Suffix:
Authorized Official - Credentials:NONE
Authorized Official - Phone:773-750-0982
Mailing Address - Street 1:5116 N NORDICA AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60656-3606
Mailing Address - Country:US
Mailing Address - Phone:773-750-0982
Mailing Address - Fax:
Practice Address - Street 1:5116 N NORDICA AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60656-3606
Practice Address - Country:US
Practice Address - Phone:773-750-0982
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency