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Organization
LINK TO WELLNESS
Active
Organization
LINK TO WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT FOREMAN (CREDENTIALING)
(630) 313-0069
Entity
Organization
Contact information
Practice address
11S270 S JACKSON ST STE 101, BURR RIDGE, IL 60527-6823
(618) 401-7140
Mailing address
9138 SHERMAN AVE, BROOKFIELD, IL 60513-1547
(618) 401-7140
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/29/2022
Last updated
08/17/2023
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