Organization
MAINE CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID R. BILLINGHAM L.C.S.W. (ASSOCIATE DIRECTOR, PROFESSIONAL SE)
(847) 696-1570
Entity
Organization
Contact information
Practice address
819 BUSSE HWY, PARK RIDGE, IL 60068-2360
(847) 696-1570
(847) 696-1587
Mailing address
819 BUSSE HWY, PARK RIDGE, IL 60068-2360
(847) 696-1570
(847) 696-1587
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1615408
BLUE CROSSBLUE SHIELD
IL
Enumeration date
03/29/2007
Last updated
02/15/2008
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