| NPI | 1487696274 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY O'CONNELL Board President 312-263-4368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: IL 180-005596) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: IL 180-001066) |
| 101Y00000X Counselor (Licence: IL 180-001599) | |
| 101Y00000X Counselor (Licence: IL 180-002780) | |
| 101Y00000X Counselor (Licence: IL 170-001433) | |
| 1041C0700X Social Worker, Clinical (Licence: IL 149-008093) | |
| 103TC0700X Psychologist, Clinical (Licence: IL 071-001959) | |
| 103TC0700X Psychologist, Clinical (Licence: IL 071-005280) | |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2020-08-22 |