Organization
BY YOUR SIDE INDIANA, LLC
Active
Other names
By Your Side
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY KOZICKI (BILLING CONTRACTING MANAGER)
(630) 590-5571
Entity
Organization
Contact information
Practice address
8201 CASS AVE, DARIEN, IL 60561-5314
(630) 590-5571
Mailing address
8201 CASS AVE, DARIEN, IL 60561-5314
(630) 590-5571
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
07/19/2021
Last updated
07/19/2021
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