| NPI | 1629785050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARLA M HELTON Billing Manager 847-695-0484 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-11-04 |
| Last Update Date | 2022-11-04 |