| NPI | 1568686764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES R PHILLIPS Com PT Roller 630-898-1938 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2020-08-22 |