| NPI | 1316151871 |
|---|---|
| Other Name | PROFESSIONAL DIAGNOSTIC SERVICES |
| Entity Type | Organization |
| Authorized Contact | KENNETH P DAVIS President 773-772-2450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: IL A-3407-0001-A) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: IL A-3407-0001-A) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2018-06-05 |