| NPI | 1114272341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARTHUR ROGGOW Authorized Official 312-942-7801 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2012-07-13 |