Organization
HORSEFEATHERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICHOLAS EB COYNE (PRESIDENT)
(847) 234-2411
Entity
Organization
Contact information
Practice address
1181 RIVERWOODS RD, LAKE FOREST, IL 60045-3459
(847) 234-2411
(847) 905-0737
Mailing address
1181 RIVERWOODS RD, LAKE FOREST, IL 60045-3459
(847) 234-2411
(847) 905-0737
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
056.006145
IL
Other
Enumeration date
08/14/2014
Last updated
08/14/2014
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