| NPI | 1043046626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN MCCORMACK CEO 312-719-8208 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 104100000X Social Worker | |
| 207Q00000X Family Medicine | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2024-09-11 |
| Last Update Date | 2024-09-11 |