| NPI | 1568046423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT M JACKSON Clinical Director 847-346-2236 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-05-07 |
| Last Update Date | 2023-11-03 |