| NPI | 1053154260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTONIA JURKOVIC Owner 773-895-4071 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2024-06-15 |
| Last Update Date | 2024-06-15 |