| NPI | 1154768471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J CLATCH Owner 847-730-3042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071.008602) |
| Enumeration Date | 2013-05-28 |
| Last Update Date | 2013-05-28 |