| Ctf Illinois | |
|
914 17th St Charleston IL 61920-2917 | |
| (708) 429-1260 | |
| Not Available |
| Full Name | Ctf Illinois |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 914 17th St, Charleston, Illinois |
| Authorized Official Name and Position | Mary Patricia Ambrosino (CEO) |
| Authorized Official Contact | 7084291260 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ctf Illinois 18230 Orland Pkwy Orland Park IL 60467-5688 Ph: (708) 429-1260 | Ctf Illinois 914 17th St Charleston IL 61920-2917 Ph: (708) 429-1260 |
| NPI Number | 1437733979 |
|---|---|
| Provider Enumeration Date | 05/11/2021 |
| Last Update Date | 05/11/2021 |
| Certification Date | 04/14/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437733979 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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