| NPI | 1023350063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA WYATT WHARTON Owner 312-259-2112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149015015) |
| Enumeration Date | 2013-03-16 |
| Last Update Date | 2013-03-16 |