| NPI | 1417769332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AHMED MEMON Medical Director 224-623-5411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-01-27 |
| Last Update Date | 2025-10-17 |