| NPI | 1396136180 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS MILLIMAN Owner 847-428-7260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 150.015365) |
| Enumeration Date | 2015-02-15 |
| Last Update Date | 2015-02-15 |