| NPI | 1164572459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON POLAND Director 847-695-8700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180004392) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2020-08-22 |