| NPI | 1598032922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA M. BLOCK Member 847-409-0050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 071006426) |
| Enumeration Date | 2011-11-30 |
| Last Update Date | 2011-11-30 |