| NPI | 1194859892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVY K FISHMAN Administrator 847-432-6080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310500000X Intermediate Care Facility, Mental Illness (Licence: IL 0023739) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2020-08-22 |