| NPI | 1588179360 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISANTHA E ANANDAPPA Physician 708-557-1930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: IL 036.132734) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MI 4301092315) |
| Enumeration Date | 2017-12-03 |
| Last Update Date | 2018-03-17 |