| NPI | 1023150919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN E WAGNER President 312-255-8111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036100517) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2020-08-22 |