| NPI | 1063789220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN CHRISTIAN HARDIE Clinical Director 312-810-5646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TH0100X Psychologist, Health Service (Licence: IL 071007352) |
| Enumeration Date | 2011-11-16 |
| Last Update Date | 2011-11-16 |