| NPI | 1518098771 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH WARDLOW Billing/Credentialing Specialist 847-548-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 104100000X Social Worker (Licence: IL 149001053) |
| 251S00000X (Licence: IL 5138-995-6) | |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2024-02-13 |