| NPI | 1649703018 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIMITRIUS R MAYO Manager, Revenue Cycle 630-572-0556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: IL A-0380-0002-A) |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2017-04-04 |