| NPI | 1770065088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINNET MENDEZ Practice Manager 773-403-2374 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: IL 180.007420) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: IL 149.018995) |
| 1041C0700X Social Worker Clinical (Licence: IL 149.013079) | |
| Enumeration Date | 2018-09-04 |
| Last Update Date | 2018-09-04 |