| NPI | 1104831643 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS P. BRENNAN Vice President 773-743-2466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071-004035) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2020-08-22 |