Organization
JOIL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LANA YAEL PECK LCPC (CLINICAL DIRECTOR)
(773) 653-3059
Entity
Organization
Contact information
Practice address
5140 W MELROSE ST, CHICAGO, IL 60641-4224
(773) 653-3059
(773) 526-7512
Mailing address
5140 W MELROSE ST, CHICAGO, IL 60641-4224
(773) 653-3059
(773) 526-7512
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
178004814
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003996307
—
IL
Enumeration date
12/20/2009
Last updated
12/20/2009
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