| Organization Name: | THE IRIS IMPACT GROUP, INC. |
| NPI Number: | 1235312604 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL A SIRI (PRESIDENT) |
| Mailing Address: | 41 E Main St Suite 108 Lake Zurich |
| State: | IL US |
| Postal Code: | 600473413 |
| Phone Number: | 8473371667 |
| Fax Number: | |
| NPI Enumeration Date: | 12/08/2007 |
| NPI Last Update Date: | 08/30/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 180006685 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |