| NPI | 1831785997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH ZIEBA Manager Of Managed Care Contracting 312-663-1130 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2020-12-14 |
| Last Update Date | 2024-06-14 |