| NPI | 1063136307 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUKHDEV SONI Medical Director 815-741-4758 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| 364SP0813X Clinical Nurse Specialist, Psych/Mental Health, Geropsychiatric | |
| Enumeration Date | 2022-09-29 |
| Last Update Date | 2022-09-29 |