| NPI | 1700923927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM CACCIATO Billing Specialist 630-572-8228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL A-0380-0004-A) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2020-08-22 |