| NPI | 1144598228 |
|---|---|
| Doing Business As | SPROUT CLINICS |
| Entity Type | Organization |
| Authorized Contact | STEPHAN MATTHEW GOMBIS Executive Director 312-794-5582 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180.007708) |
| Enumeration Date | 2011-12-05 |
| Last Update Date | 2011-12-05 |