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General NPI Number Information
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NPI Number | 1144931023
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Entity Type | Organization
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Legal Business Name | OUTREACH COUNSELING CENTER YORK
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Dates
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Enumeration Date | 12/12/2022
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Last Update Date | 09/27/2023
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Provider Practice Location Address
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Address Line | 1S450 SUMMIT AVE STE 315
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City | OAKBROOK TERRACE
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State | IL
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Zip | 60181-3990
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Country | US
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Telephone | 630-682-1910
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Fax |
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Provider Business Mailing Address
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Address Line | 373 S SCHMALE RD
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City | CAROL STREAM
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State | IL
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Zip | 60188-2774
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Country | US
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Telephone | 630-682-1910
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF CLINICAL ADMIN SERVICES
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Name | LEO KIM
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Credential |
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Telephone | 630-871-2100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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