Organization
THE MATHERS CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAMESH VEMURI (OWNER)
(815) 444-9999
Entity
Organization
Contact information
Practice address
715 W JUDD ST, WOODSTOCK, IL 60098-3186
(815) 444-9999
Mailing address
145 S VIRGINIA ST SUITE C, CRYSTAL LAKE, IL 60014
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
036054365
IL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
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Other
Enumeration date
03/04/2016
Last updated
01/26/2017
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