| Wheaton Youth Outreach | |
|
122 W Liberty Dr Wheaton IL 60187-5124 | |
| (630) 682-1910 | |
| (630) 682-0655 |
| Full Name | Wheaton Youth Outreach |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 122 W Liberty Dr, Wheaton, Illinois |
| Authorized Official Name and Position | Brian T. Lux (DIRECTOR OF CLINICAL SERVICES) |
| Authorized Official Contact | 6306821910 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wheaton Youth Outreach 373 S Schmale Rd Ste 102 Carol Stream IL 60188-2771 Ph: (630) 682-1910 | Wheaton Youth Outreach 122 W Liberty Dr Wheaton IL 60187-5124 Ph: (630) 682-1910 |
| NPI Number | 1750948501 |
|---|---|
| Provider Enumeration Date | 05/28/2019 |
| Last Update Date | 01/15/2021 |
| Certification Date | 01/15/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750948501 | NPI | - | NPPES |
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