| NPI | 1134979644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI A SMITH Office Manager 847-816-6441 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2024-03-26 |
| Last Update Date | 2024-03-26 |