| NPI | 1104164128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL RILEY FANCHER Clinical Psychologist 312-854-9764 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IL 071008207) |
| Enumeration Date | 2013-01-25 |
| Last Update Date | 2013-01-25 |