| NPI | 1891124210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA DENISE COLVILLE Licensed Clinical Social Worker 773-269-9400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149013723) |
| Enumeration Date | 2013-11-06 |
| Last Update Date | 2013-11-06 |