Lorelle Beaugard

Individual provider Active NPI Developmental Therapist · Park Forest, IL

NPI 1801088091 · NPPES record last updated Aug 13, 2007

Key facts

NPI
1801088091
Entity type
Individual (NPI type 1)
Primary specialty
Developmental Therapist 222Q00000X
Practice address
211 Grant St
Park Forest, IL 60466-1013
Phone
(708) 748-3382
NPI assigned
Aug 13, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X Yes

Addresses

Primary practice location

211 Grant St
Park Forest, IL 60466-1013

Mailing address

211 Grant St
Park Forest, IL 60466-1013
Phone (708) 748-3382

Other providers in Park Forest, IL

All providers in Park Forest, IL · Developmental Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.