| NPI | 1003147232 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE W FABER Owner 630-926-4873 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: IL 149-008480) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: IL 149-008480) |
| Enumeration Date | 2010-01-28 |
| Last Update Date | 2013-07-09 |