| NPI | 1275058745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA MARTIN Primary Therapist 847-291-6805 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 178.012613) |
| Enumeration Date | 2017-08-07 |
| Last Update Date | 2022-07-21 |