Provider Demographics
NPI:1326207846
Name:RLM OF JOLIET,PC
Entity Type:Organization
Organization Name:RLM OF JOLIET,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:MADISON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:815-741-3007
Mailing Address - Street 1:1520 N ROCK RUN DR
Mailing Address - Street 2:30 A
Mailing Address - City:CRESTHILL
Mailing Address - State:IL
Mailing Address - Zip Code:60403-3153
Mailing Address - Country:US
Mailing Address - Phone:815-741-3009
Mailing Address - Fax:815-741-8322
Practice Address - Street 1:1520 N ROCK RUN DR
Practice Address - Street 2:30 A
Practice Address - City:CRESTHILL
Practice Address - State:IL
Practice Address - Zip Code:60403-3153
Practice Address - Country:US
Practice Address - Phone:815-741-3009
Practice Address - Fax:815-741-8322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)