Provider Demographics
NPI:1649666439
Name:LITTLE SPROUTS PEDIATRIC THERAPY SERVICES, INC
Entity type:Organization
Organization Name:LITTLE SPROUTS PEDIATRIC THERAPY SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:773-516-1750
Mailing Address - Street 1:4324 BLANCHAN AVE.
Mailing Address - Street 2:
Mailing Address - City:BROOKEFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60513
Mailing Address - Country:US
Mailing Address - Phone:773-516-1750
Mailing Address - Fax:773-257-9103
Practice Address - Street 1:4324 BLANCHAN AVE.
Practice Address - Street 2:
Practice Address - City:BROOKEFIELD
Practice Address - State:IL
Practice Address - Zip Code:60513
Practice Address - Country:US
Practice Address - Phone:773-516-1750
Practice Address - Fax:773-257-9103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-08
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.009304225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty