Provider Demographics
NPI:1871173211
Name:SUNFLOWER PEDIATRIC THERAPY & FAMILY SERVICES
Entity type:Organization
Organization Name:SUNFLOWER PEDIATRIC THERAPY & FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP/L
Authorized Official - Phone:630-607-9062
Mailing Address - Street 1:7920 WOODGLEN LN APT 101
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60516-4577
Mailing Address - Country:US
Mailing Address - Phone:630-607-9062
Mailing Address - Fax:
Practice Address - Street 1:7920 WOODGLEN LN APT 101
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60516-4577
Practice Address - Country:US
Practice Address - Phone:630-233-4977
Practice Address - Fax:630-566-5856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-09
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty