| NPI | 1942916572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY L WILKES CEO 773-437-7816 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 163WP0809X Registered Nurse, Psych/Mental Health, Adult |
| 101YM0800X Counselor, Mental Health | |
| 207QA0401X Family Medicine, Addiction Medicine | |
| Enumeration Date | 2023-01-26 |
| Last Update Date | 2023-12-05 |