| NPI | 1104129287 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID PRESTON MACKINNON President 630-325-4770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071004301) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IL 166000403) |
| Enumeration Date | 2010-12-13 |
| Last Update Date | 2010-12-13 |