| NPI | 1730695560 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUES A GOURGUECHON Senior Counselor 312-203-9211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149002222) |
| Enumeration Date | 2017-12-15 |
| Last Update Date | 2018-06-16 |