| NPI | 1003190737 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MEDALIE Clinical Psychologist 312-337-9900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: 071.008089) |
| Enumeration Date | 2011-09-29 |
| Last Update Date | 2011-09-29 |