| NPI | 1457836249 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERI LYNN LAUREANO COO 847-284-0430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2018-09-27 |
| Last Update Date | 2021-04-19 |