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2905 Willow Ln Apt C1 Zion IL 60099-1462 | |
(847) 377-8170 | |
(847) 782-6281 |
Full Name | |
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Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 2905 Willow Ln Apt C1, Zion, Illinois |
Authorized Official Name and Position | Angela Cooper (CFO) |
Authorized Official Contact | 8473778000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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3010 Grand Ave Waukegan IL 60085-2321 Ph: (847) 377-8000 | 2905 Willow Ln Apt C1 Zion IL 60099-1462 Ph: (847) 377-8170 |
NPI Number | 1538380647 |
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Provider Enumeration Date | 05/02/2007 |
Last Update Date | 09/10/2024 |
Certification Date | 09/10/2024 |
Identifier | Type | State | Issuer |
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1538380647 | NPI | - | NPPES |
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