| NPI | 1124483227 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA J WATKINS Clinical Social Worker 224-330-7438 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: IL 149014668) |
| Enumeration Date | 2015-12-16 |
| Last Update Date | 2015-12-16 |