Northwestern Lake Counseling

NPI 1043510621 - Early Intervention Provider Agency - 252Y00000X

NPI Details
NPI 1043510621
Enumeration Date 10/28/2010
Last Updated 11/01/2010
Entity Type Healthcare Provider
Active Over 6 years ago
Authorized Information
Name DARLENE LETA DARLENE
Position OWNER/DIRECTOR
Phone (847) 587-8400
Fax (847) 587-8407
Practice Location
17 WEST GRAND AVE.
FOX LAKE IL, 60020, US
Phone (847) 587-8400
Fax (847) 587-8407
Business Location
17 W GRAND AVE
FOX LAKE IL, 60020-1209, US
Phone (847) 587-8400
Fax (847) 587-8407
Toxanomy
Taxonomy Code 252Y00000X
License State Illinois
License Number A-2237-0001-A
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According to our database, Northwestern Lake Counseling NPI is 1043510621, taxonomy code is 252Y00000X and license number is A-2237-0001-A, license state is located at Illinois. Northwestern Lake Counseling physically located at 17 West Grand Ave., Fox Lake IL, 60020. NPI Number 1033115704 has the healthcare provider type.

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1043510621 NPI number is provided on an as is basis without warranty of any kind. 1043510621 is maintained by the National Plan & Provider Enumeration System. The contents of Northwestern Lake Counseling are for informational purposes only.