| NPI | 1174148167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY CRICK Administrator 847-791-4384 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2020-06-15 |
| Last Update Date | 2020-06-15 |