| NPI | 1225483456 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | EUGENE ISYANOV Clinical Services Director 847-673-8577  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 251S00000X Community/Behavioral Health | 
| Additional Taxonomies | 251B00000X Case Management | 
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2016-04-25 | 
| Last Update Date | 2016-09-02 |