| NPI | 1114319969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN MICHELLE FALLON Social Worker 847-773-5545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149012590) |
| Enumeration Date | 2015-03-02 |
| Last Update Date | 2015-03-02 |