| NPI | 1023507019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE KRISTINE BRENNER Managing Provider 847-497-8374 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149015344) |
| Enumeration Date | 2018-05-04 |
| Last Update Date | 2018-05-04 |