Organization
JOLIET CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRK GOHSMAN CRADC (REGIONAL DIRECTOR)
(815) 630-2164
Entity
Organization
Contact information
Practice address
807 W JEFFERSON ST UNIT P, SHOREWOOD, IL 60404-7301
(815) 630-2164
Mailing address
807 W JEFFERSON ST UNIT P, SHOREWOOD, IL 60404-7301
(815) 630-2164
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/31/2019
Last updated
05/31/2019
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