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General NPI Number Information
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NPI Number | 1790232981
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Entity Type | Organization
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Legal Business Name | TK BEHAVIORAL, LLC
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Dates
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Enumeration Date | 09/06/2016
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Last Update Date | 08/28/2023
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Provider Practice Location Address
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Address Line | 14620 S LA GRANGE RD
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City | ORLAND PARK
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State | IL
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Zip | 60462-2544
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Country | US
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Telephone | 630-343-2336
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Fax |
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Provider Business Mailing Address
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Address Line | 40 TIMBERLINE DR
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City | LEMONT
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State | IL
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Zip | 60439-3848
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Country | US
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Telephone | 630-257-9600
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Fax |
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Authorized Official
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Title or Position | VP AND SECRETARY
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Name | MR. BRIAN P FARLEY
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Credential |
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Telephone | 615-861-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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