| NPI | 1194851477 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVAN A. WOLFSON Licensed Clinical Psychologist 847-433-4450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071-005558) |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2014-05-14 |