| NPI | 1518418177 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE MAGIDA Owner 224-558-2722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 180.010603) |
| Enumeration Date | 2016-10-19 |
| Last Update Date | 2016-10-19 |