| NPI | 1538532908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA C KONICK President 630-206-4060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 251S00000X (Licence: IL 071008083) |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2015-11-07 |
| Last Update Date | 2024-06-01 |