| NPI | 1811409196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN LEWIS Administrative Assistant Special Ed 224-577-4105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS1000X Clinic/Center, Student Health |
| Enumeration Date | 2017-10-26 |
| Last Update Date | 2017-10-26 |