| NPI | 1770199689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE DZADO Insurance Biller 312-372-6707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-09-17 |
| Last Update Date | 2020-09-17 |