Organization
PREVENTATIVE MENTAL HEALTHCARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH S ANGELILLO (DIRECTOR)
(630) 968-1181
Entity
Organization
Contact information
Practice address
1001 OGDEN AVE, LL5, DOWNERS GROVE, IL 60515-2865
(630) 968-1181
(630) 322-9977
Mailing address
1001 OGDEN AVE, LL5, DOWNERS GROVE, IL 60515-2865
(630) 968-1181
(630) 322-9977
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
03/02/2007
Last updated
12/02/2014
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