| NPI | 1871103242 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TALHA JOHN BALOCH Lead Psychiatrist/President 708-325-8252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry | |
| 251S00000X Community/Behavioral Health | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2020-07-31 |
| Last Update Date | 2023-08-08 |