| NPI | 1720170772 |
|---|---|
| Other Name | LLC |
| Entity Type | Organization |
| Authorized Contact | JEFFREY JOSEPH SHORE President 312-782-3888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149001234) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2020-08-22 |