| NPI | 1104297100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAUREEN R FORD President 312-860-0708 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071003720) |
| Enumeration Date | 2015-10-15 |
| Last Update Date | 2015-10-15 |