| NPI | 1013452168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH CANELAS Md 708-829-7422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036085902) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036084800) |
| Enumeration Date | 2016-12-28 |
| Last Update Date | 2017-03-15 |