| NPI | 1134270036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY SHAH CEO, Owner 847-991-4800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Additional Taxonomies | 261QM2800X Clinic/Center, Methadone Clinic (Licence: IL A-6192-0001-A) |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2021-08-26 |