| NPI | 1053615492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FELICIA A DAVIS CEO 312-659-7812 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| Enumeration Date | 2010-12-28 |
| Last Update Date | 2010-12-28 |