| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1606 23rd St, Zion, Illinois |
| Authorized Official Name and Position | Kelly M Schuler (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 8474415600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
405 Central Ave Northfield IL 60093-3006 Ph: (847) 441-5600 | 1606 23rd St Zion IL 60099-2345 Ph: (847) 246-4552 |
| NPI Number | 1619309879 |
|---|---|
| Provider Enumeration Date | 07/30/2013 |
| Last Update Date | 07/30/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619309879 | NPI | - | NPPES |
| 036054322 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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