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421 W Water St Waukegan IL 60085-5527 | |
| (847) 360-9560 | |
| (847) 360-0195 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 421 W Water St, Waukegan, Illinois |
| Authorized Official Name and Position | Christopher Anthony Schrantz (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 8472456214 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
421 W Water St Waukegan IL 60085-5527 Ph: (847) 360-9560 | 421 W Water St Waukegan IL 60085-5527 Ph: (847) 360-9560 |
| NPI Number | 1053619528 |
|---|---|
| Provider Enumeration Date | 03/08/2011 |
| Last Update Date | 05/03/2021 |
| Certification Date | 05/03/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053619528 | NPI | - | NPPES |
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