| NPI | 1174989438 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ALLEN KRAGE Clinical Psychologist 312-288-2014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071008322) |
| Enumeration Date | 2016-01-01 |
| Last Update Date | 2016-01-01 |