| NPI | 1619295870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEVILA MCDOUGAL Billing Coordinator 847-274-1222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.014137) |
| Enumeration Date | 2010-05-12 |
| Last Update Date | 2010-05-12 |