Organization
FRESH START BEHAVIORIAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOEL K CARROLL DO (MEDICAL DIRECTOR)
(708) 757-2444
Entity
Organization
Contact information
Practice address
8 SURREY BROOK PLZ, SAUK VILLAGE, IL 60411-4913
(708) 757-2444
(708) 757-2449
Mailing address
8 SURREY BROOK PLZ, SAUK VILLAGE, IL 60411-4913
(708) 757-2444
(708) 757-2449
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
36093329
IL
Other
Enumeration date
06/09/2008
Last updated
06/09/2008
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