| NPI | 1174185672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORELL MARIN Executive Director 773-255-8155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| 252Y00000X Early Intervention Provider Agency | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QP2000X Clinic/Center, Physical Therapy | |
| 261QX0100X Clinic/Center, Occupational Medicine | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2019-07-03 |
| Last Update Date | 2019-07-03 |