| NPI | 1649696774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA RICCI Billing Manager 847-894-0218 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149014398) |
| Enumeration Date | 2014-03-13 |
| Last Update Date | 2014-03-13 |