| NPI | 1124362116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY ANN ODDO Owner 312-217-1802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 149.015549) |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2012-11-15 |