| NPI | 1104831999 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL A OMAN Co Owner 815-639-9405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180-001079) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180-001148) |
| 101YP2500X Counselor, Professional (Licence: IL 180-003390) | |
| 101YP2500X Counselor, Professional (Licence: IL 180-005053) | |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2020-08-22 |