| NPI | 1093074502 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER RANDOLPH Director 312-863-3033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: IL 071004821) |
| Enumeration Date | 2012-05-04 |
| Last Update Date | 2012-05-04 |