| NPI | 1114628351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER O'CONNELL Licensed Clinical Social Worker 847-907-0501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2023-03-14 |
| Last Update Date | 2023-03-14 |