| NPI | 1568518520 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JON VERNON Owner 773-414-4577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149009584) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2018-03-17 |