| NPI | 1063811149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS EB COYNE President 847-234-2411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: IL 056.006145) |
| Enumeration Date | 2014-08-14 |
| Last Update Date | 2014-08-14 |