| NPI | 1104146802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK STUTRUD President 847-635-4600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IL 04092) |
| Enumeration Date | 2010-06-03 |
| Last Update Date | 2020-01-08 |