Organization
CHILDREN'S CLINIC, LLC
Active
Other names
Chicago Children's Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT E DANIELS PH.D. (MEMBER)
(312) 587-1742
Entity
Organization
Contact information
Practice address
778 W FRONTAGE RD, STE. 123, NORTHFIELD, IL 60093-1209
(312) 587-1742
(312) 376-1047
Mailing address
778 W FRONTAGE RD, STE. 123, NORTHFIELD, IL 60093-1209
(312) 587-1742
(312) 376-1047
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
071006306
IL
Other
Enumeration date
12/17/2013
Last updated
12/17/2013
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