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General NPI Number Information
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NPI Number | 1376102814
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Entity Type | Organization
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Legal Business Name | RL GROUP
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Dates
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Enumeration Date | 06/09/2019
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Last Update Date | 11/19/2020
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Provider Practice Location Address
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Address Line | 2008 N LAWLER AVE
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City | CHICAGO
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State | IL
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Zip | 60639-3136
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Country | US
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Telephone | 708-860-1201
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Fax | 708-221-6679
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Provider Business Mailing Address
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Address Line | 511 MANISTEE AVE
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City | CALUMET CITY
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State | IL
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Zip | 60409-3311
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Country | US
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Telephone | 708-860-1201
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Fax | 708-221-6679
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Authorized Official
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Title or Position | MANAGER
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Name | MS. LYNN FIELDS TYLER
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Credential |
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Telephone | 708-860-1201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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