| NPI | 1225364078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN JEFFERS Executive Director 847-358-5510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X (Licence: IL 3B00-IPI-053) |
| Enumeration Date | 2009-10-29 |
| Last Update Date | 2021-05-05 |