| NPI | 1003961343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUDHIR M GOKHALE Md 708-636-2211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: IL 036058650) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: IL 036058650) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2023-06-22 |