| NPI | 1134904923 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATIE ODETTE WASHINGTON COLE Owner 312-373-0879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry |
| Enumeration Date | 2023-08-29 |
| Last Update Date | 2024-05-18 |