Organization
KHALIL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOOMAN KESHAVARZI (EXECUTIVE DIRECTOR)
(224) 622-3116
Entity
Organization
Contact information
Practice address
999 N MAIN ST, SUITE 103, GLEN ELLYN, IL 60137-3581
(630) 474-4414
(630) 230-3364
Mailing address
999 N MAIN ST, SUITE 103, GLEN ELLYN, IL 60137-3581
(630) 474-4414
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
178.010934
IL
101YP2500X
Professional Counselor
180.008541
IL
101YP2500X
Professional Counselor
180009783
IL
103TC0700X
Clinical Psychologist
Primary
071007457
IL
2084P0800X
Psychiatry Physician
036093319
IL
Other
Enumeration date
09/17/2015
Last updated
09/23/2015
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