| NPI | 1750769006 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMI CHOWDHARY Billing/Credentialing Manager 630-846-1644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: MI 2084P0800X) |
| Enumeration Date | 2015-05-07 |
| Last Update Date | 2015-05-07 |