| NPI | 1407481401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH G. WIERSUM VP Of Finance 847-441-5603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-03-10 |
| Last Update Date | 2020-03-12 |