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655 Rockland Rd Suite 207 Lake Bluff IL 60044-1782 | |
| (847) 521-0116 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 655 Rockland Rd, Lake Bluff, Illinois |
| Authorized Official Name and Position | Elaine Dafnis (CLINICAL MENTAL HEALTH COUNSELOR) |
| Authorized Official Contact | 8475210116 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
655 Rockland Rd Suite 207 Lake Bluff IL 60044-1782 Ph: () - | 655 Rockland Rd Suite 207 Lake Bluff IL 60044-1782 Ph: (847) 521-0116 |
| NPI Number | 1689063992 |
|---|---|
| Provider Enumeration Date | 01/10/2015 |
| Last Update Date | 01/10/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689063992 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 180009427 (Illinois) | Primary |
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