| NPI | 1114450061 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEO GERDOV Owner 630-988-5364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: IL 180009919) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038011689) |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2018-06-21 |