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103 N 11th Ave Suite #101 St Charles IL 60174-2289 | |
| (224) 795-1712 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor - Professional |
| Location | 103 N 11th Ave, St Charles, Illinois |
| Authorized Official Name and Position | Kate Evans (PRESIDENT) |
| Authorized Official Contact | 2247951712 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
103 N 11th Ave Suite #101 St Charles IL 60174-2289 Ph: () - | 103 N 11th Ave Suite #101 St Charles IL 60174-2289 Ph: (224) 795-1712 |
| NPI Number | 1265775886 |
|---|---|
| Provider Enumeration Date | 04/02/2013 |
| Last Update Date | 04/02/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265775886 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 180.006508 (Illinois) | Primary |
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