| NPI | 1144345471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB L MOSKOVIC Owner 847-590-0050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 036040989) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2009-10-19 |