| NPI | 1023342565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL L STOLLER Lcsw 773-934-8721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.012969) |
| Enumeration Date | 2009-10-01 |
| Last Update Date | 2009-10-01 |