NPI | 1023286770 |
---|---|
Entity Type | Organization |
Authorized Contact | ULYSSES JEROME JEFFERSON Patient Revenue Coordinator 773-542-1150 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
101YM0800X Counselor, Mental Health | |
101YP2500X Counselor, Professional | |
103T00000X Psychologist | |
104100000X Social Worker | |
1041C0700X Social Worker, Clinical | |
207QA0401X Family Medicine, Addiction Medicine | |
2084A0401X Psychiatry & Neurology, Addiction Medicine | |
251S00000X (Licence: IL A-0579-0001-A) | |
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IL 16008) | |
261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: IL A-0579-001A) | |
276400000X Rehabilitation, Substance Use Disorder Unit (Licence: IL A-0579-0001-A) | |
Enumeration Date | 2008-02-15 |
Last Update Date | 2022-12-20 |