| Judson University | |
|
1151 N State St Elgin IL 60123-1404 | |
| (847) 628-2464 | |
| (847) 628-2044 |
| Full Name | Judson University |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1151 N State St, Elgin, Illinois |
| Authorized Official Name and Position | Carol Didominicis (CLINICAL SUPERVISOR) |
| Authorized Official Contact | 8476282464 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Judson University 1151 N State St Elgin IL 60123-1404 Ph: (847) 628-2464 | Judson University 1151 N State St Elgin IL 60123-1404 Ph: (847) 628-2464 |
| NPI Number | 1356860571 |
|---|---|
| Provider Enumeration Date | 09/19/2017 |
| Last Update Date | 09/19/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356860571 | NPI | - | NPPES |
| NONE | Other | NONE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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