| NPI | 1184787038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG V SHOWALTER Medical Director 630-810-0186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: IL A-3027-0001-A) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2020-05-14 |