| NPI | 1124801402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA PEREZ MERAZ Executive Administrative Assistant 847-524-8800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-08-18 |
| Last Update Date | 2024-04-10 |