| NPI | 1104250067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY L COLEMAN Clinical Psychologist 630-898-5322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071006641) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180008137) |
| 101YP2500X Counselor, Professional (Licence: IL 180007319) | |
| 103T00000X Psychologist | |
| 103TC0700X Psychologist, Clinical | |
| 1041C0700X Social Worker, Clinical (Licence: IL 149007223) | |
| 1041C0700X Social Worker, Clinical (Licence: IL 149007369) | |
| Enumeration Date | 2013-08-28 |
| Last Update Date | 2023-12-15 |