| Il Ltc Mht | |
|
5454 Fargo Ave Skokie IL 60077-3210 | |
| (847) 834-4923 | |
| Not Available |
| Full Name | Il Ltc Mht |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 5454 Fargo Ave, Skokie, Illinois |
| Authorized Official Name and Position | Jay Greenberger (OWNER) |
| Authorized Official Contact | 8478344923 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Il Ltc Mht 5454 Fargo Ave Skokie IL 60077-3210 Ph: (847) 834-4923 | Il Ltc Mht 5454 Fargo Ave Skokie IL 60077-3210 Ph: (847) 834-4923 |
| NPI Number | 1699547158 |
|---|---|
| Provider Enumeration Date | 10/26/2023 |
| Last Update Date | 10/26/2023 |
| Certification Date | 10/26/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699547158 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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