Organization
MATHERS CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAMESH B VEMURI M.D. (OWNER)
(815) 444-9999
Entity
Organization
Contact information
Practice address
145 S VIRGINIA ST, CRYSTAL LAKE, IL 60014-7226
(815) 444-9999
(815) 986-1363
Mailing address
145 S VIRGINIA ST, CRYSTAL LAKE, IL 60014-7226
(815) 444-9999
(815) 986-1363
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)
—
IL
Other
Enumeration date
03/04/2016
Last updated
01/25/2017
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