| NPI | 1245862457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARLENE L MALONEY Executive Director 847-336-7733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Enumeration Date | 2020-02-05 |
| Last Update Date | 2020-02-05 |