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Organization
MATHERS RECOVERY LLC
Active
Organization
MATHERS RECOVERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SRIHARI VEMURI (CFO)
(815) 444-9999
Entity
Organization
Contact information
Practice address
145 S VIRGINIA ST, CRYSTAL LAKE, IL 60014-7226
(815) 444-9999
(847) 531-1296
Mailing address
145 S VIRGINIA ST, CRYSTAL LAKE, IL 60014-7226
(815) 444-9999
(847) 531-1296
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
—
NULL
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
—
—
261QM2800X
Methadone Clinic
—
NULL
Other
Enumeration date
12/05/2022
Last updated
10/08/2024
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