| NPI | 1235255993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY GERARD LARSON President 630-444-1801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.012296) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149.005583) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2009-10-23 |