| NPI | 1184036121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH JEAN CHILES Clinical Director 708-510-4755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071007594) |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2014-05-27 |