| Northwest Therapy Group, Inc. | |
|
118 S Main St Ste 5 Wauconda IL 60084-1859 | |
| (847) 508-6399 | |
| Not Available |
| Full Name | Northwest Therapy Group, Inc. |
|---|---|
| Speciality | Counselor - Professional |
| Location | 118 S Main St Ste 5, Wauconda, Illinois |
| Authorized Official Name and Position | Alexis Aguilar (OWNER) |
| Authorized Official Contact | 8475086399 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Therapy Group, Inc. 28038 W Homestead Ct Lakemoor IL 60051-6662 Ph: (847) 508-6399 | Northwest Therapy Group, Inc. 118 S Main St Ste 5 Wauconda IL 60084-1859 Ph: (847) 508-6399 |
| NPI Number | 1073198909 |
|---|---|
| Provider Enumeration Date | 03/11/2021 |
| Last Update Date | 03/11/2021 |
| Certification Date | 03/11/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073198909 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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