Organization
COUNTY OF LAKE
Active
Other names
Nineteenth Judicial Circuit
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DENA TRAYLOR PSY.D. (DIRECTOR OF PSYCHOLOGICAL SERVICES)
(847) 377-3675
Entity
Organization
Contact information
Practice address
24647 N MILWAUKEE AVE, VERNON HILLS, IL 60061-1576
(847) 377-7920
Mailing address
215 W WATER ST, WAUKEGAN, IL 60085-5616
(847) 377-3675
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
071.006552
IL
Other
Enumeration date
06/21/2011
Last updated
06/21/2011
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