| NPI | 1174989552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK COPERTINO Clinical Professional Counselor 630-440-9013 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: IL 180.009951) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: IL 180.009951) |
| Enumeration Date | 2016-01-14 |
| Last Update Date | 2016-01-14 |