| NPI | 1518036425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUGENE ISYANOV Clinical Services Director 847-673-8577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 251S00000X (Licence: IL A-1587-0003-A) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2024-10-07 |