Provider Demographics
NPI:1336625136
Name:SUNFLOWER PATTERSON INC NFP
Entity Type:Organization
Organization Name:SUNFLOWER PATTERSON INC NFP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:DT
Authorized Official - Phone:708-856-7821
Mailing Address - Street 1:16718 GENTRY LN APT 102
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-1949
Mailing Address - Country:US
Mailing Address - Phone:708-856-7821
Mailing Address - Fax:
Practice Address - Street 1:16718 GENTRY LN APT 102
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-1949
Practice Address - Country:US
Practice Address - Phone:708-856-7821
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-14
Last Update Date:2018-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILKG27080916P222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Single Specialty