| NPI | 1053052134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS ANDREW FERENCE CEO 630-334-2019 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine | |
| 251S00000X | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| 207QA0401X Family Medicine, Addiction Medicine | |
| 207RA0401X Internal Medicine, Addiction Medicine | |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2023-12-07 |