| NPI | 1114602760 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | UMEKO JONES VP 312-405-8536 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine |
| Enumeration Date | 2023-06-21 |
| Last Update Date | 2023-06-21 |