| NPI | 1164932513 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY SENEVIRATNE Director Of Operations 847-895-4540 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2017-10-31 |