| NPI | 1194937359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY LEE KETTERING President 847-934-8475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 060004613) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2022-10-06 |